Prevention of Bacterial Endocarditis Using Antibiotics

What is bacterial endocarditis?

Bacterial endocarditis is an infection of the lining inside of the heart muscle and valves. Bacteria attach themselves to the lining, usually on the heart valves. They grow there and can damage the valves. Children with some kinds of heart defects or heart diseases (such as rheumatic fever) are more likely to get this infection. Children with other heart defects are better off not taking antibiotic medicines before dental work.

When should my child take antibiotics?

Dental Procedures:

Dental procedures that involve bleeding are more likely to result in bacteria in the blood stream than at other times. These bacteria might cause problems for the heart or heart valves of certain children. Bacteria in the bloodstream (bacteremia) can usually be prevented by taking one dose of antibiotics before medical or dental procedures.

Your child should take a dose of antibiotics before a dental procedure when bleeding is expected, such as:

  • cleaning teeth
  • cutting tissue
  • probing the gums
  • reimplanting a tooth
  • placing orthodontic bands.

Your child does not need to take the medicine if there will be no bleeding. Dental work that usually does not cause bleeding includes:

  • filling cavities
  • getting a shot to numb the mouth
  • adjusting braces that are already in place
  • getting fluoride treatments.

Antibiotics are not needed when your child loses baby teeth.

Medical Procedures:

Your child should take antibiotics before surgeries and procedures that involve:

  • The respiratory system. This includes the nose, mouth, and upper part of the airway (such as removing tonsils or having a rigid bronchoscopy).
  • The stomach and intestines. This includes the esophagus (the swallowing tube), bile ducts, and colon.
  • The genitals or urinary system. This includes the bladder and the urethra (the tube that urine goes through).

Your child does not need antibiotics for procedures such as:

  • putting in ear tubes
  • circumcision.

Your healthcare provider can decide if your child needs antibiotics. Always talk to your provider if you have any questions about the need for antibiotics.

Be sure to tell your provider if your child has any allergies to any medicines.

Card For Patient to Carry

 
+-Cut-here-----------------------------+Cut-here
  Date _______________________________
  Name _______________________________
  should be treated before certain
  dental and medical procedures for
  prevention of bacterial endocarditis
  because of the following heart
  condition: _________________________

  Prescribed by: _____________________
+-Cut-here-----------------------------+Cut-here
Written by Robert Brayden, MD, Associate Professor of Pediatrics, University of Colorado.
Published by RelayHealth.
Last modified: 2009-08-13
Last reviewed: 2009-04-07
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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