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Recommendations by the American Heart Association

Adnan S. Dajani, MD; Alan L. Bisno, MD; Kyung J. Chung, MD; David T. Durack, MB, DPhil; Michael Freed, MD; Michael A. Gerber, MD; Adolf W. Karchmer, MD; H. Dean Millard, DDS, MS; Shahbudin Rahimtoola, MB, FRCP; Stanford T. Shulman, MD; Chatrchai Watanakunakorn, MD; Kathryn A. Taubert, PhD

JAMA. 1990;264(22):2919-2922.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

SURGICAL and dental procedures and instrumentations involving mucosal surfaces or contaminated tissue commonly cause transient bacteremia that rarely persists for more than 15 minutes. Blood-borne bacteria may lodge on damaged or abnormal heart valves or on the endocardium or the endothelium near congenital anatomic defects, resulting in bacterial endocarditis or endarteritis. Although bacteremia is common following many invasive procedures, only a limited number of bacterial species commonly cause endocarditis. It is impossible to predict which patient will develop this infection or which particular procedure will be responsible.

Certain cardiac conditions are more often associated with endocarditis than others (Table 1). Furthermore, certain dental and surgical procedures are much more likely to initiate the bacteremia that results in endocarditis than are other procedures (Table 2). Prophylactic antibiotics are recommended for patients at risk for developing endocarditis who are undergoing those procedures most likely to produce bacteremia with organisms that commonly cause . . . [Full Text PDF of this Article]

Footnotes
This article is one of a series sponsored by the American Heart Association.

This is a statement from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association.

The Council on Dental Therapeutics of the American Dental Association has approved this statement as it relates to dentistry.

Reprint requests to Office of Scientific Affairs, American Heart Association, 7320 Greenville Ave, Dallas, TX 75231 (Dr Taubert).

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