patients with prosthetic valves, or who have previously had
endocarditis.
Recommendations for prophylaxis vary between countries.
Dental (causing gingival bleeding), oropharyngeal, gastro-
intestinal and urological procedures are usually considered a
risk.^2 The use of antibiotic prophylaxis is routine during cardiac
surgery, flucloxacillin, plus an aminoglycoside, or a
cephalosporin being common choices.
RReeffeerreenncceess
1 Van Der Meer JTM, Van Wijk W, Thompson J et al. Efficacy of antibiotic
prophylaxis for prevention of native valve endocarditis. Lancet
1992; 333399 : 135–9.
2 Leport C, Horstkotte D, Burckhardt D, and the group of experts of the
International Society for Chemotherapy. Antibiotic prophylaxis for
infective endocarditis from an international group of experts towards a
European consensus. Eur Heart J1995; 1166 ((ssuuppppll BB)): 126–31.
FFuurrtthheerr rreeaaddiinngg
Dajani AS, Bisno AL, Chung KJ et al. Prevention of bacterial endo-
carditis. Recommendations by the American Heart Association. JAMA
1990; 226644 : 2919–22.