The American Heart Association has dramatically restricted recommendations for antibiotic prophylaxis, advising prophylaxis only for pts at highest risk of severe morbidity and death from endocarditis. Prophylaxis is recommended only for those dental procedures involving manipulation of gingival tissue or the periapical region of the teeth or perforation of the oral mucosa (including respiratory tract surgery). Table 87-4 lists the high-risk cardiac lesions for which prophylaxis is advised, and Table 87-5 lists the recommended antibiotic regimens for this purpose.

For a more detailed discussion, see Karchmer AW: Infective Endocarditis, Chap. 118, p. 789, in HPIM-17.