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American Association of Oral and Maxillofacial Surgeons

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AHA issues new infective endocarditis guideline

April 25th, 2007

On April 19, 2007 the American Heart Association (AHA) published its updated recommendations for the prevention of infective endocarditis in heart patients scheduled to undergo dental procedures. The new guideline will significantly affect oral and maxillofacial surgery practice patterns and simplify the management of many patients.

Contrary to long-held beliefs, the AHA's review of more than 50 years of scientific literature revealed that there is no definitive evidence that the prophylactic use of antibiotics prior to dental procedures prevents infective endocarditis (IE). Given that all drugs carry risks and that the bacteria that cause IE might become resistant to antibiotics, AHA now recommends that prophylactic antibiotic use be reserved for those patients who would have the worst outcomes if IE were contracted, such as patients with artificial heart valves, a history of endocarditis, certain serious congenital heart conditions and heart transplant patients who develop a problem with a heart valve.

A group appointed by the AHA that included experts in infectious disease and cardiology and members representing the ADA developed the guideline. The guideline was endorsed by the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society.

The complete text of the Guideline may be found on the ADA's Web site.