TABLE 3

Endocarditis Prophylaxis

Cardiac Conditions for Which Endocarditis Prophylaxis Is RecommendedProcedures for Which Antibiotic Prophylaxis Is RecommendedProcedures for Which Antibiotic Prophylaxis Is Not Recommended
Personal history of previous infective endocarditisDental procedures with gingival manipulation or oral mucosa perforationProcedures on the genitourinary or gastrointestinal tract
Prosthetic cardiac valvesInvasive respiratory tract procedures involving mucosal incision (ie, tonsillectomy and adenoidectomy)Routine injections through noninfected tissue
Unrepaired cyanotic CHD, including those palliated with shunts and conduitsProcedures on infected skin or musculoskeletal tissueProsthodontic or orthodontic appliance placement without oral mucosa perforation
First 6 mo after complete repair of CHD, with prosthetic material or deviceLip bleeding or oral mucosa trauma
Repaired CHD with residual defects (persistent leaks or abnormal flows at or adjacent to prosthetic patch or device)Loss of deciduous teeth
Heart transplant patients with abnormal cardiac valve functionBronchoscopy without mucosal incision
Piercing or tattooing through noninfected skin
Vaginal delivery or hysterectomy
  • Adapted from Wilson W, Taubert KA, Gewitz M, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116(15):1736–1754 and Baltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation. 2015;132(15):1487–1515.