Heart Disease and Pre-medication

Are you a cardiac patient?  Do you take an antibiotic before receiving dental treatment?  Five years ago the recommendations changed drastically and many people were taken off the pre-med regimin.  Here’s why we recommend it—and when we don’t:

Infective endocarditis.  It’s a nasty little infection of the vessels in your heart and can be quite dangerous.  Bacteria can be dumped into the bloodstream during dental procedures and like to stick to artificial heart valves, certain heart defects, and heart transplants.   However, some hearts are susceptible to this kind of infection even without any of these obvious predisposions, so the pre-med is recommended for anyone who has contracted this kind of infection before.   People who fall under any of these categories are considered high risk for endocarditis. 

We no longer recommend pre-medication for those who fall under moderate risk, firstly, because the risk of creating super-bugs by over prescribing antibiotics continues to grow and, secondly, because evidence of efficacy (or how effective antibiotics are at preventing endocarditis) continues to be unclear.  We know it reduces the amount of bacteria in the bloodstream but the evidence is still a bit hazy.

If your doctor has recommended a pre-medication of anti-biotics, they should be taken 30 to 60 minutes before your appointment.  However, the American Heart Association states that if it was neglected before the appointment, it can be administered up to two hours after the procedure.


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Filed under antibiotics, heart disease, pre-medication

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