Taking antibiotics before certain procedures to prevent endocarditis
If you are at increased risk for endocarditis, you may be given antibiotics before certain procedures to prevent infection. If you take preventive antibiotics, they are generally given about 1 hour before the procedure.
Antibiotics are recommended before the following:
- Dental procedures
- Removal of a tooth (extraction), implants, or reimplantation of teeth lost due to injury
- Periodontal procedures, such as oral surgery, scaling, root planing, and probing
- Gum surgery
- Initial placement of orthodontic bands (not the brackets)
- Teeth cleaning, if bleeding is expected
- Respiratory tract (airway) procedures
- Removal of the tonsils or adenoids
- Surgery of the respiratory tract, including putting a rigid tube in your throat to look into your breathing tubes (rigid bronchoscopy)
- Stomach and intestinal tract procedures
- Widening (dilation) of the tube that goes from the mouth to the stomach (esophagus)
- Repair of blood vessels in the esophagus
- An intestinal tract procedure that involves moving a tube down through the throat into the stomach and then placing a small catheter in the bile duct
- Surgery on the stomach or intestines
- Urinary system procedures
- Prostate surgery
- A procedure that involves looking into the bladder through a lighted scope (cystoscopy)
- Widening (dilation) of the tube (urethra) through which urine flows out of the bladder
If you are at increased risk of getting endocarditis, you should talk with your doctor about taking antibiotics to prevent endocarditis before having any of the procedures or surgeries above.
Antibiotics are NOT needed for the following:
- Dental procedures
- Restoration or replacement of a tooth, unless significant bleeding is expected
- Shots to numb your mouth
- The part of a root canal where the dentist builds up new tooth material (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
- Fluoride treatments
- Dental X-rays
- Loss of a baby tooth (primary tooth)
- Respiratory tract (airway) procedures
- Insertion of a tube through the nose or mouth to open or widen the airway, give anesthetic, or remove secretions (endotracheal intubation)
- A procedure in which a flexible tube is guided down your throat to look into your breathing tubes (flexible bronchoscope) with or without biopsy. (Antibiotics are optional for people at high risk of developing an infection.)
- Incision of the eardrum for placement of tubes (tympanostomy)
- Stomach and intestinal tract procedures
- Echocardiography down through the esophagus (transesophageal echocardiography, or TEE)
- Endoscopy with or without a biopsy
- Reproductive system procedures
- Removal of the uterus through the vagina (vaginal hysterectomy). (Antibiotics are optional for women at high risk of infection.)
- Delivery of a baby through the vagina (vaginal delivery). (Antibiotics are optional for women.)
- Delivery of a baby surgically (caesarean section)
- In uninfected tissue: uterine dilation and curettage (D&C), therapeutic abortion, sterilization procedures, insertion or removal of intrauterine devices (IUD birth control devices)
- Other procedures
- Cardiac catheterization, including balloon angioplasty
- Implantation of cardiac pacemakers
- Implantation of defibrillators and coronary stents
- Incision or biopsy of surgically scrubbed skin
- Circumcision
Ask your doctor about other procedures that might require you to take preventive antibiotics.
| Author: | Douglas Dana Robin Parks, MS | Last Updated: April 4, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Kathleen Romito, MD - Family Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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