Prophylactic antibiotic premedication is the practice of prescribing limited antibiotic therapy to dental patients who are at risk of contracting microbial disease as a result of invasive dental procedures.
Oral bacteria can enter the bloodstream during dental procedures and are normally destroyed by the body's immune system. In certain cases, however, bacteria may settle on abnormal heart valves or tissue that has been weakened by surgery or an existing heart problem. Infective endocarditis, an infection of the endocardium or heart valves, can be the result. Prophylactic premedication with approved antibiotics manages and reduces the risk of infection.
A study published in November 2000 has called into question whether antibiotic prophylaxis is necessary for dental treatment. Such treatment, the study concluded, does not seem to be a risk factor for infective endocarditis. The American Dental Association (ADA) and American Heart Association have stated that their current recommendations are valid, although further research is warranted. The ADA's Council on Scientific Affairs continues to monitor, analyze, and assess research in prophylactic premedication with antibiotics.
The use of prophylactic premedication in oral health care has undergone many changes since its inception. Dosages have been decreased, and the conditions requiring premedication have changed. Premedication for patients who are recipients of large joint prostheses is no longer universally recommended. Some associations of orthopedists, for instance, state that routine antibiotic coverage is not necessary for patients who have joint prostheses and are undergoing dental procedures. It is recognized, however, that decisions regarding premedication should be made on an individual basis.
Cathy Hester Seckman R.D.H., The Gale Group Inc., Gale, Detroit,