Prophylaxis against infective endocarditis

Based on NICE guideline [Prophylaxis against infective endocarditis: Clinical guideline [CG64] Published date: March 2008]

Cardiac conditions at increased risk of developing infective endocarditis:

  • acquired valvular heart disease with stenosis or regurgitation

  • hypertrophic cardiomyopathy

  • previous infective endocarditis

  • structural congenital heart disease
    EXCLUDING: isolated atrial septal defect, fully repaired ventricular septal defect or fully repaired patent ductus arteriosus, and closure devices that are judged to be endothelialised

  • valve replacement

Antibiotic prophylaxis against infective endocarditis is NOT RECOMMENDED ROUTINELY for

  • dental procedures

  • non‑dental procedures involving gastrointestinal, genitourinary or respiratory tract

However, If a person at risk of infective endocarditis is receiving antimicrobial therapy because they are undergoing a gastrointestinal or genitourinary procedure at a site where there is a suspected infection, the person should receive an antibiotic that covers organisms that cause infective endocarditis.

Chlorhexidine mouthwash SHOULD NOT be offered as prophylaxis against infective endocarditis to people at risk of infective endocarditis undergoing dental procedures.

Dr Rajesh VarmaProphylaxis against infective endocarditis