Debate & O P I N I O N Which Antibiotic Prophylaxis Guidelines for Infective Endocarditis Should Canadian Dentists Follow? Contact Author Herve Y. Sroussi, DMD, PhD; Ashwin R. Prabhu, BDS; Dr. Epstein Joel B. Epstein, DMD, MSD, FRCD(C) Email:
[email protected] For citation purposes, the electronic version is the definitive version of this article: www.cda-adc.ca/jcda/vol-73/issue-5/401.html ental providers must keep up to date 2 weeks following a procedure, dental proced- with antibiotic prophylaxis guidelines ures conducted even months earlier may be Dfor infectious endocarditis (IE) as these questioned as causative of IE.4 Furthermore, guidelines represent standards of care and periodontal and dental disease increase the determine medicolegal standards. A survey risk of bacteremia with activities of daily of Canadian dentists revealed that practi- living and may more commonly cause bac- tioners tend to employ antibiotic prophylaxis teremia; therefore, good oral care is of para- according to the guidelines in place at the mount importance in patients with conditions time of their graduation from dental school that place them at risk for IE. — guidelines that often do not meet the cur- To reduce the risk of IE following dental rent standards,1 as both the American Heart procedures, prophylactic measures have Association (AHA)2 and the British Society been developed by experts in the fields of for Antimicrobial Chemotherapy (BSAC)3 have microbiology, epidemiology, cardiology and currently updated their recommendations. dentistry. The principle preventive measure Host factors that increase the risk of IE recommended is the use of prophylactic anti- include specific cardiac abnormalities, a biotics before certain dental procedures in pa- previous episode of IE and the extent of the tients identified as at risk.