Can we really do without antibiotic prophylaxis for infective endocarditis?

Abstract

Current guidance recommends against the use of antibiotic prophylaxis around the time of dental intervention for the prevention of infective endocarditis. The authors report the case of a previously well-patient with an asymptomatic isolated ventricular septal defect (VSD) who developed evidence of infective systemic and pulmonary emboli following dental treatment. A diagnosis of severe endocarditis of a previously normal native mitral valve was made. She subsequently underwent surgical repair of her mitral valve, and closure of her VSD. She was deemed fit for discharge on parenteral antibiotics on the thirtieth postoperative day. The authors highlight the need for further re-evaluation of the issues surrounding antibiotic prophylaxis for endocarditis in the context of dental procedures.

Infective endocarditis and orthodontic implications in children: A review of the literature

“…The risk of IE itself in association with invasive dental procedures is controversial in the literature, with some studies showing an increased risk, [33][34][35][36] and other studies showing no increased risk. 18,[37][38][39][40][41][42] Because it is unethical to conduct prospective clinical trials to assess the relationship between invasive dental procedures, antibiotic prophylaxis, and IE, the literature is limited.…”