Editorial
Antibiotics before dental procedures for endocarditis prophylaxis: back to the future
| The first 150 words of the full text of this article appear below. |
Infective endocarditis (IE) is a rare infection of the endocardial surface, with an incidence of approximately 4 per 100 000 person-years. Uniformly fatal in the pre-antimicrobial era, the mortality from IE remains high (~20%). Before the introduction of antibiotics, dentists were called upon to prevent IE in persons with valvar lesions by helping to maintain good oral health. Over the past 60 years, however, antibiotic prophylaxis has been seen as protective, and dental care as potentially hazardous to patients at risk of IE. This view is erroneous, and likely harmful. A call to refocus our energies back on maintaining good oral health is long overdue.
Dental procedures and endocarditisThe relation between oral microbial flora and infective
endocarditis was recognised early in the 20th century. With knowledge that disruption of infected oral mucosal barriers results in
bacteraemia, medical wisdom in the first half of the 20th century
taught that patients at risk of
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