In 2007 the American Heart Association (AHA) updated their guidelines for the use of antibiotic prophylaxis (AP) only for patients at the highest risk of adverse outcomes should they acquire viridans group streptococcal infective endocarditis (VGS IE). This eliminated many patients who had previously been recommended to use AP, including patients with mitral valve prolapse and heart murmurs. Since that time there has been no evidence that this reduction in AP use has led to an increase in cases of VGS IE in patients undergoing invasive dental procedures (IDPs).

The most recent AHA Guideline update was completed in 2021 and confirms the recommendation to only use AP for those patients in the highest risk categories for adverse outcomes should they develop IE. This course (Module 2) reviews the following topics:

• Specific conditions that require AP
• Those conditions that do not require AP
• Bioprosthetic (pig) valves
• Appropriate antibiotics for AP with sample prescriptions
• How to manage patients who forget to take AP or who are currently taking a therapeutic antibiotic
• Situations not addressed by the guidelines
• Research related to the effectiveness of AP to prevent IE as well as IE risk from poor oral hygiene
• Signs and symptoms of IE
• Appropriate dental clearance for patients undergoing valve replacement surgery
• Aortic aneurysm repair and if AP is necessary

Ensuring Safe and Evidence-Based Care for At-Risk Patients

Infective Endocarditis (IE) is a serious, life-threatening infection of the heart’s inner lining and valves, often caused by viridans group streptococci (VGS) in the setting of invasive dental procedures (IDPs). However, over the years, research has shown that the widespread use of antibiotic prophylaxis (AP) was unnecessary for many patients once believed to be at risk.

In 2007, the American Heart Association (AHA) revised its guidelines, narrowing the use of AP only to patients with the highest risk of adverse outcomes should they develop IE. This eliminated AP recommendations for many individuals, including those with mitral valve prolapse and heart murmurs. Importantly, studies have since shown no increase in cases of VGS IE despite this significant reduction in AP use.

The most recent AHA guideline update (2021) reaffirms that only select high-risk patients should receive AP before IDPs. This course (Module 2) will provide essential knowledge to ensure dental professionals apply current best practices for antibiotic prescribing while reducing unnecessary risk to patients.

Course Topics

• Specific conditions that require AP under current AHA guidelines

• Conditions that no longer require AP and the evidence supporting this change

• Understanding bioprosthetic (pig) valves and their implications for AP

• Appropriate antibiotics for AP, including sample prescriptions for different patient scenarios

• How to manage patients who forget to take AP or those already on therapeutic antibiotics

• Clinical situations not addressed by the guidelines and how to navigate them

• Review of research on AP effectiveness in preventing IE and the role of oral hygiene in infection prevention

• Recognizing the signs and symptoms of IE to improve early diagnosis and patient outcomes

• Guidelines for dental clearance in patients undergoing valve replacement surgery

• Aortic aneurysm repair: When is AP necessary?

Why This Course Matters

Understanding when to prescribe antibiotic prophylaxis is crucial for ensuring patient safety and adherence to the latest guidelines. Overprescription can lead to unnecessary risks, including antibiotic resistance and adverse drug reactions, while underprescription in high-risk cases can result in life-threatening infections. This course will equip you with the knowledge and confidence to make evidence-based decisions that align with the most up-to-date AHA recommendations.

Register Today

Join us to gain a comprehensive understanding of infective endocarditis risk and antibiotic prophylaxis in dentistry. By completing this course, you’ll be able to ensure the safest care for your patients while adhering to the latest evidence-based guidelines.

Take the next step in responsible prescribing – enroll now!

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