How do you take your Antibiotics?

[Eowyn Rose]

I saw my surgeon lasts Tuesday for my 8 weekly check up. He advised me strongly that if i need any dental i need to take the antibiotics intravainous an hour before treatment.
He does not trust antibiotics if taken orally to prevent an infections of my mechanical valve.
Anyway how are you going about having dental work done?
How do you take antibiotics?
Thanks
Eowyn Rose

 

[inlaguna]

Guidelines have change somewhat over the years, but I have always taken antibiotics orally. That has been for 40 plus years ( until recently for a bicuspid valve). I do not have a mechanical valve, but the docs told me to keep to the antiobiotics 1 hour before dental procedure with my tissue valve.

 

[Rich]

I've had my mechanical valve for eight and a half years.
I still take my anti-biotics orally one hour prior to my appointment.
The only times I get an IV is prior to or during invasive surgical procedures, but never for normal dental work.

 

[tobagotwo]

Intravenous Predental Antibiotics

Intravenous Predental Antibiotics

Your best course might be to consider asking your dentist whether he/she feels it would be appropriate to wait until three months after your OHS for your particular dental needs. Then the risk is much lower.

The first three months after a valve implant are the most concerning for bacterial endocarditis. Perhaps that is why he is recommending intravenous antibiotics at this time.

I wonder if he has any suggestions how or where you can get such treatment, as dentists generally won't do that, and who will pay for it (check your insurance - they might not reimburse for it).

In general, your surgeon's opinion seems to vary from the guidelines of the American College of Cardiology, the American Heart Association, and the American Dental Association:
http://www.americanheart.org/presenter.jhtml?identifier=1745

They also have a handy, downloadable wallet card: http://www.americanheart.org/presenter.jhtml?identifier=3003000

If you need a filling (restorative work), antibiotics are not even recommended by the guidelines in most cases. If you need a cleaning, they are absolutely recommended.

Again, though, the surgeon may be recommending this approach due to the fact that you're still healing internally.

You may well decide you want to go with your regular cardiologist's opinion on this one, further down the road. After three months, the value of intravenous antibiotics might be very difficult to prove to an insurance company, much less the AHA, for a "simple" VR.

All of the studies that I have seen refer to a two-to-three-month window of opportunity for bacterial endocarditis after a "simple" valve replacement. Perhaps they would recommend intravenous and a longer waiting period also, if you had a portion of your aorta replaced as well as the valve, with new tissue growing on and through it.

Best wishes,

 

[inlaguna]

I should have added that my surgeon asked me to wait 6 months before any dental work too. Thanks Bob

Dan

 

[tobagotwo]

For reference, from: http://www.americanheart.org/presen...identifier=1745

Table 2. Dental Procedures and Endocarditis Prophylaxis

Endocarditis prophylaxis recommended*

Dental extractions
Periodontal procedures including surgery, scaling and root planing, probing, and recall maintenance
Dental implant placement and reimplantation of avulsed teeth
Endodontic (root canal) instrumentation or surgery only beyond the apex
Subgingival placement of antibiotic fibers or strips
Initial placement of orthodontic bands but not brackets
Intraligamentary local anesthetic injections
Prophylactic cleaning of teeth or implants where bleeding is anticipated

Endocarditis prophylaxis not recommended

Restorative dentistry? (operative and prosthodontic) with or without retraction cord?
Local anesthetic injections (nonintraligamentary)
Intracanal endodontic treatment; post placement and buildup
Placement of rubber dams
Postoperative suture removal
Placement of removable prosthodontic or orthodontic appliances
Taking of oral impressions
Fluoride treatments
Taking of oral radiographs
Orthodontic appliance adjustment
Shedding of primary teeth


*Prophylaxis is recommended for patients with high- and moderate-risk cardiac conditions.

? This includes restoration of decayed teeth (filling cavities) and replacement of missing teeth.

? Clinical judgment may indicate antibiotic use in selected circumstances that may create significant bleeding.

 

[McCln]

I take oral antibiotics. I would say it matters how it is taken, as long as there is no alergic reaction, I no longer take amoxicillin. Just as long as you are protected from infection. Just my two cents. Thanks.

 

[Gemma]

Jim takes amoxycillin in powdered form which he mixes with a glass of water and drinks 1 hour before visiting the dentist. This is prescribed by the dentist, and Jim has a wallet-sized "endocarditis warning card" from the British Heart Foundation which his cardio gave him.