Antibiotic prophylaxis (endocarditis)
AHA 2021 regimens, single dose 30–60 min before the procedure.
Who: prosthetic valves, previous IE, certain congenital heart disease, cardiac transplant with valvulopathy — for procedures manipulating gingiva/periapical region or perforating mucosa.
Clindamycin is no longer recommended (AHA 2021).
UK vs US
NICE CG64: routine prophylaxis is not recommended. SDCEP advises discussing with the patient's cardiologist for those at special risk; if given, use amoxicillin 3 g PO (or clindamycin 600 mg if penicillin-allergic) per UK cardiology advice.
AHA 2021 / ADA: prophylaxis for the high-risk cardiac groups above only, using the table.
Sources
- AHA Scientific Statement — Prevention of viridans group streptococcal infective endocarditis (2021)US
- ADA — Antibiotic prophylaxis prior to dental proceduresUS
- NICE CG64 — Prophylaxis against infective endocarditisUK
- SDCEP — Drug Prescribing for DentistryUK
- ESC Guidelines — Endocarditis (2023)EU
Checked against these sources on 2026-10-22. Guidelines change — open the source to confirm.
Summarised from the sources above. Always verify against current local guidelines and the patient's medical history.
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