Spectrum: Local Antimicrobial Stewardship, for Yangon Children's Hospital

Prevention

Prophylaxis should be limited to the highest risk patients (patients with the highest incidence of infective endocarditis and/or highest risk of adverse outcome from infective endocarditis)

Good oral hygiene and regular dental review are of particular important for prevention of infective endocarditis

Cardiac conditions for which prophylaxis is recommended when a high risk procedure is performed

  • Patients with any prosthetic valve or prosthetic material

  • Patients with a previous episode of infective endocarditis

  • Patients with congenital heart disease:

  • Any type of cyanotic congenital heart disease

  • Any type of congenital heart disease repaired with a prosthetic material, placed surgically or by percutaneous techniques, up to 6 months after the procedure or lifelong if residual shunt or valvular regurgitation remains

Antibiotic prophylaxis is not recommended in other forms of valvular or congenital heart diseases

Procedures that necessitate antibiotic prophylaxis in high risk patients
  1. Manipulation of gingival tissue or periapical region of teeth or perforation of oral mucosa
  2. Established infection of gastrointestinal (GI) or genitourinary tract (GU), or for those who receive antibiotics to prevent wound infection or sepsis associated with GI or GU procedure
  3. Patients with enterococcal urinary infection or colonization
  4. An invasive procedure of the respiratory tract that involves biopsy or incision of the respiratory mucosa
  5. Any procedure involving infected skin, skin suture or musculoskeletal tissue
  6. Placement of prosthetic valves or intravascular or intracardiac material

Antibiotic Regimen

At-Risk Dental Procedure

Additional Information

Please see MPS guidelines for full details of preventive regimens