People Who Need Antibiotics to Prevent Endocarditis
have a normal heart, you have a low risk for endocarditis. But if
you have a problem with your heart that affects normal blood flow through the heart, it is more
likely that bacteria or fungi will attach to heart tissue. This puts you at a
higher risk for endocarditis.
If you have certain heart conditions, getting endocarditis is even more
dangerous for you. These heart conditions include:
If you have any of these heart conditions, you may need to take
antibiotics before you have certain dental or surgical procedures that could
put bacteria or fungi into your blood. The antibiotics lower your risk of
getting endocarditis. If you do not have these conditions, antibiotics are not likely to help you.
Your doctor can tell you whether you need to take antibiotics. Before you
have any medical, dental, or surgical procedures, tell all other health
professionals who may treat you that you are at risk for endocarditis.
Your doctor can issue you a special card to carry in your wallet if
you require preventive antibiotics before certain dental or surgical
procedures. Your condition and specific antibiotic requirements are outlined on
this card. The card is signed by your doctor.
Why not everyone should use antibiotics
Antibiotics are useful in minimizing the risk of
endocarditis. But in order to protect
your health, your doctor may not always recommend them. The medical community has several reasons for not advising all
people with valve problems to take antibiotics:
Taking antibiotics may not be needed.
Taking antibiotics may be dangerous to your health if you are
allergic to the drug.
Taking excessive antibiotics promotes the
development of stronger,
antibiotic-resistant bacteria that are harder to kill
with currently available medicines.
Antibiotic resistance occurs when bacteria (such as those that
cause endocarditis) have the ability to resist drugs that were previously
able to kill them. Antibiotic resistance is most common in situations
that involve improper, unneeded, and incomplete use of prescription
antibiotics. But resistance can also occur through correct antibiotic
Antibiotic resistance is dangerous, because one type of bacteria
can acquire the ability to survive certain drugs and then exchange this ability
with other types of bacteria. When resistance to a particular medicine is
widespread, the antibiotic becomes ineffective. Then scientists must find an
adequate replacement. The only way for bacteria to develop resistance is
through exposure to these antibiotics. So doctors try to use these drugs only when
appropriate and necessary. This reduces the chances of resistance.
Always try to prevent antibiotic resistance, since resistant
bacteria are more dangerous to your valves. This can be done by:
Completing the course of drugs that you have
been given. Antibiotics typically take several days to kill bacteria. If
you take a partial course, you are teaching bacteria to survive the
Not stockpiling partial prescriptions and self-dosing
Wilson W, et al. (2007). Prevention of endocarditis. Guidelines from the American Heart Association. A guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Res
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
How this information was developed to help you make better health decisions.