Procedures that may require antibiotics to prevent endocarditis
The Heart and Stroke Foundation of Canada recommends preventive (prophylactic) antibiotics for some people who are at increased risk of developing endocarditis. These people should have preventive antibiotics before they have certain procedures that may release bacteria into the bloodstream.
If you are at increased risk for endocarditis, talk with your doctor about the need for preventive antibiotics before having any of these procedures or surgeries. Although antibiotics can reduce the risk of developing endocarditis, taking them does not provide 100% protection.
If your doctor determines that you need to take preventive antibiotics, they generally are given about 1 hour before the procedure.
When antibiotics are recommended Dental procedures
- Tooth removal (extractions), implants, or reimplantation of teeth lost from injury
- Periodontal procedures, such as oral surgery, scaling, root planing, and probing
- Gum surgery
- Initial placement of orthodontic bands (not brackets)
- Teeth cleaning, if bleeding is expected
- Some types of shots used to numb the mouth
Respiratory tract (airway) procedures
- Tonsil or adenoid removal
- Respiratory tract surgery, including a procedure called a rigid bronchoscopy that places a rigid tube in the throat to look into breathing tubes
Stomach and intestinal tract procedures
- Widening (dilation) of the tube that connects the mouth to the stomach (esophagus)
- Blood vessel repair in the esophagus
- Stomach, intestinal, or gallbladder surgery
Urinary system procedures
- Prostate surgery
- Looking into the bladder through a lighted scope (cystoscopy)
- Widening (dilation) of the urethra, the tube through which urine flows out of the bladder
When antibiotics are NOT needed Dental procedures
- Tooth restoration or replacement, unless significant bleeding is expected
- During the buildup of the new tooth material phase of a root canal (intracanal endodontic treatment, post placement, and buildup)
- Placement of rubber dams
- Removal of stitches after dental surgery
- Placement, adjustment, or removal of mouth (orthodontic) appliances (such as braces or retainers)
- Oral impressions
- Mouth X-rays
- Loss of baby tooth (primary tooth)
- Some types of shots used to numb the mouth
Respiratory tract (airway) procedures
- Insertion of a tube through the nose or mouth to open or widen the airway, give anesthesia, or remove secretions (endotracheal intubation)
- A procedure in which a flexible tube is guided down your throat to look into your breathing tubes (flexible bronchoscopy, with or without biopsy)—antibiotics are optional for high-risk patients
- Eardrum incision for tube placement (tympanostomy)
Stomach and intestinal tract procedures
- Echocardiography that requires a tube passed through the stomach (transesophageal echocardiography, or TEE)
- Some intestinal tract procedures that require moving a tube down the throat into the stomach or intestines (endoscopy) with or without gastrointestinal biopsy
Urinary system procedures
- Removal of the uterus through the vagina (hysterectomy)—antibiotics are optional for high-risk patients
- Delivery of a baby through the vagina (vaginal delivery)—antibiotics are optional for high-risk patients
- Delivery of a baby through surgery (caesarean section)
- Certain procedures on uninfected tissue: urethral catheterization, uterine dilation and curettage (D&C), therapeutic abortion, sterilization procedures, insertion or removal of intrauterine birth control devices (IUDs)
Other procedures
- Cardiac catheterization, including balloon angioplasty
- Implanted cardiac pacemakers
- Implanted defibrillators and coronary stents
- Incision or biopsy of surgically scrubbed skin
- Circumcision
| Author: | Douglas Dana Robin Parks, MS | Last Updated: May 22, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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