Nancy
Well-known member
http://www.medicalnewstoday.com/medicalnews.php?newsid=69557
Just wonder what you all think about this.
Just wonder what you all think about this.
New AHA guidelines for endocarditis
- Thread starter Nancy
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Mary
Nancy said:
I had just read an article about avoiding endocarditis in the ACHA's Spring publication, and I do have a few concerns.
The new guidelines recommend antibiotics for mechanical valves; does that mean tissue valves too?
And although our son hasn't developed any problems YET with his BAV, I would still feel better if he had antibiotics before his next dental cleaning.
So I guess put me down in the "undecided" column.
C
Curtsmum
I would still like my son to have antibiotics before any dental work, he hasn't got his mechanical valve yet but i wouldn't be happy any other way. Althow he his young and shouldn't need any for a long time .He had antibiotics when he had paper stiches on his face and i would prefere to get them. Paula
.He had antibiotics when he had paper stiches on his face and i would prefere to get them. Paula
O
OldNick
As one who contracted endocarditis a few months following dental cleaning, and had to undergo hospitalized treatment with the most powerful antibiotics available, followed by replacement of my mitral and aortic valves with St. Jude mechanicals, I have no intention of altering my practice of medicating before ANY dental procedure. As it appears in the new guidelines, for me, that is their recommendation as well.
I also limit my dental cleanings to once a year, to minimize my chances of a problem.
Jim N.
I also limit my dental cleanings to once a year, to minimize my chances of a problem.
Jim N.
Andrew'sMom
Well-known member
I would feel much safer to err on the side of caution and continue to have Andrew take his antibiotics, even though he has not been replaced yet. It doesn't seem logical to forego the antibiotics and risk the damage & complications caused by BE.... no matter how small the risk is. In fact, I just scheduled his dental cleaning this morning and the dentist asked me which pharmacy I wanted his RX called into ... I guess they haven't gotten wind the new guidelines yet -- I will have to talk with them and see what they think, as well as Andrew's card!
Thanx for the update Nancy!
Thanx for the update Nancy!
S
Susan BAV
Conclusions from AHA - Complete Guideline Text - pdf
Conclusions from AHA - Complete Guideline Text - pdf
"Conclusions--The major changes in the updated recommendations include the following: (1) The Committee concluded that only an extremely small number of cases of infective endocarditis might be prevented by antibiotic prophylaxis for dental procedures even if such prophylactic therapy were 100% effective. (2) Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis. (3) For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. (4) Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of infective endocarditis. (5) Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary or gastrointestinal tract procedure. These changes are intended to define more clearly when infective endocarditis prophylaxis is or is not recommended and to provide more uniform and consistent global recommendations."
Conclusions from AHA - Complete Guideline Text - pdf
"Conclusions--The major changes in the updated recommendations include the following: (1) The Committee concluded that only an extremely small number of cases of infective endocarditis might be prevented by antibiotic prophylaxis for dental procedures even if such prophylactic therapy were 100% effective. (2) Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis. (3) For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. (4) Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of infective endocarditis. (5) Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary or gastrointestinal tract procedure. These changes are intended to define more clearly when infective endocarditis prophylaxis is or is not recommended and to provide more uniform and consistent global recommendations."
C
cocoalab
This obviously got my attention
This obviously got my attention
Just FYI Andrew did not get BE from any dental work. He has a tissue valve but still takes antibiotics before dental proceedures.
From my understanding that only reduces theoretically BE from a strept type infection which is common in the mouth and not so much the staff auriolus(sp?) that Andrew got.
I say do what you can to prevent it but don't think it is a magic pill. We still have no idea where Andrew got this bug. It may very well have been from a cut on his hand but have no way to trace it. The cardiologist in Fargo told me he is always telling his patients to not bite their nails or cuticles. I'd never head that and andrew is a nail biter. That is just one possible explaination.
Just my two cents worth but by all means do what you can to avoid infection.
heart hugs,
This obviously got my attention
Just FYI Andrew did not get BE from any dental work. He has a tissue valve but still takes antibiotics before dental proceedures.
From my understanding that only reduces theoretically BE from a strept type infection which is common in the mouth and not so much the staff auriolus(sp?) that Andrew got.
I say do what you can to prevent it but don't think it is a magic pill. We still have no idea where Andrew got this bug. It may very well have been from a cut on his hand but have no way to trace it. The cardiologist in Fargo told me he is always telling his patients to not bite their nails or cuticles. I'd never head that and andrew is a nail biter. That is just one possible explaination.
Just my two cents worth but by all means do what you can to avoid infection.
heart hugs,
francie12
Well-known member
Wow. Thanks Nancy. This is going to take some thought. Antibiotics are not without their downside...I strongly suspect the penicillin that Matt took for two dentist visits to be implicated in his year and a half of GERD (thankfully no longer a problem). I'm also undecided at this point and will be eager to read all of the responses here. It will be hard to send him for a teeth cleaning withouit those pills!
debster913
Well-known member
Right before I came home from the hospital after my valve repair, the nurse warned me about always taking antibiotics before dental work, etc., and to avoid dental procedures for six months after surgery. That's why, back in October, I was pretty nervous about getting my teeth cleaned and had a conversation with my cardio about pre-medicating, the dental cleaning being necessary, and the like. As a former non-flossing night grinder, I had given myself a pretty nasty case of gingivitis. I needed the cleaning, and at both my dentist's and cardio's recommendation, I get cleanings every three months now as I'm more predisposed to plaque build-up than are others.
Anyway, I just got my teeth cleaned two days ago, and as always, the Biaxin makes me a tad nauseated. I've been taking antibiotics pre-procedure since I was old enough to go to the dentist. I have no problem with it. Unless Dr. V tells me I don't need to take antibiotics, I'll still do it. Besides, even with the valve repair, Dr. V classifies me at "high risk" (and the #1 reason why I shouldn't get pregnant). I'd better be safe than sorry, and if I ever were to end up with BE, well, it happens.
Thanks for the info, Nancy. I'll ask the cardio about it when I see him this summer.
Debi
Anyway, I just got my teeth cleaned two days ago, and as always, the Biaxin makes me a tad nauseated. I've been taking antibiotics pre-procedure since I was old enough to go to the dentist. I have no problem with it. Unless Dr. V tells me I don't need to take antibiotics, I'll still do it. Besides, even with the valve repair, Dr. V classifies me at "high risk" (and the #1 reason why I shouldn't get pregnant). I'd better be safe than sorry, and if I ever were to end up with BE, well, it happens.
Thanks for the info, Nancy. I'll ask the cardio about it when I see him this summer.
Debi
briansmom
Well-known member
I don't know if this should be on this thread or another new thread. I have a friend that got bacterial endocarditis from a teeth cleaning. He did not know that he had BAV. He got a new tissue valve about a year ago. TODAY, he had to get some crowns. His docs made him go to the hospital and get IV antibiotics before going to the dentist. Have any of you heard of this?
Adrienne
Well-known member
briansmom said:
After I had endocarditis in 2004 (which came about out of the blue since I always tood antibiotics before going to the dentist), the infectious disease specialist who treated me at the hospital and saw that I had severe regurgitation (at that time) said I should get IV antibiotics before going to the dentist. So, that's what I did (what a drag it was) until after my surgery. I now am back to oral antibiotics.
sue943
Well-known member
I was at the dentist last week and he mentioned new guidelines and this would be for UK dentists. He said antibiotics were now only necessary for the high risk patients, and they didn't come higher risk than me as I have had endocarditis and have two mechanical valves.
If I was a cardiac patient who was not super high risk I think I would not be comfortable to stop antibiotics if I had previously been taking them.
If I was a cardiac patient who was not super high risk I think I would not be comfortable to stop antibiotics if I had previously been taking them.
KristyW
Well-known member
Weighing in on the Subject
Weighing in on the Subject
Hi y'all,
I work at a dental office and I have an artificial valve. I've been pondering this release by the ADA since Tuesday when I read it in the ADA "newspaper". It seems that the ADA and the Cardiologists have got together and really done their homework. Antibiotic resistance is a very disturbing trend, and broad spectrum antibiotics like amoxicillin definitely have their drawbacks.
For most of us on this site there will be no change in how we premedicate for a dental appointment. Artificial valves and a history of infective endocarditis are the first 2 conditions given for taking prophylactic antibiotics. Those with tissue valves need to check with their cardiologists. The article really doesn't deal with that.
Remember that everyone has some risk of endocarditis even if they don't have any heart defects. The object is to only give antibiotics to those at the greatest risk. Broad spectrum antibiotics not only kill harmful bacteria, but also beneficial bacteria. They can wreak havoc on digestive systems, the urinary tract and gynocological systems. They don't necessarily kill the strongest of the bacteria which is why we have the drug-resistant bacteria problem now.
The paragraph above the new guidelines really spells out why this change is being made. "Scientists also found no compelling evidence that taking antibiotics prior to a dental procedure prevents IE in patients who are at risk of developing a heart infection. Their hearts are already often exposed to bacteria from the mouth, which can enter their bloodstream during basic daily activities such as brushing or flossing. The new guidelines are based on a comprehensive review of published studies that suggests IE is more likely to occur as a result of these everyday activities than from a dental procedure.
Now don't take this to mean that you shouldn't brush or floss...PLEASE Everyone should keep their mouth as clean as possible and their gums pink, firm & healthy. Brushing and flossing daily and professional cleaning at least twice a year is the best tool we have to keep the bacteria in check in our mouths.
Since I have an artifical valve, I'll continue to take my premeds. I'm just glad that the medical community is looking at the evidence and not just "it's always been done that way."
Weighing in on the Subject
Hi y'all,
I work at a dental office and I have an artificial valve. I've been pondering this release by the ADA since Tuesday when I read it in the ADA "newspaper". It seems that the ADA and the Cardiologists have got together and really done their homework. Antibiotic resistance is a very disturbing trend, and broad spectrum antibiotics like amoxicillin definitely have their drawbacks.
For most of us on this site there will be no change in how we premedicate for a dental appointment. Artificial valves and a history of infective endocarditis are the first 2 conditions given for taking prophylactic antibiotics. Those with tissue valves need to check with their cardiologists. The article really doesn't deal with that.
Remember that everyone has some risk of endocarditis even if they don't have any heart defects. The object is to only give antibiotics to those at the greatest risk. Broad spectrum antibiotics not only kill harmful bacteria, but also beneficial bacteria. They can wreak havoc on digestive systems, the urinary tract and gynocological systems. They don't necessarily kill the strongest of the bacteria which is why we have the drug-resistant bacteria problem now.
The paragraph above the new guidelines really spells out why this change is being made. "Scientists also found no compelling evidence that taking antibiotics prior to a dental procedure prevents IE in patients who are at risk of developing a heart infection. Their hearts are already often exposed to bacteria from the mouth, which can enter their bloodstream during basic daily activities such as brushing or flossing. The new guidelines are based on a comprehensive review of published studies that suggests IE is more likely to occur as a result of these everyday activities than from a dental procedure.
Now don't take this to mean that you shouldn't brush or floss...PLEASE
Everyone should keep their mouth as clean as possible and their gums pink, firm & healthy. Brushing and flossing daily and professional cleaning at least twice a year is the best tool we have to keep the bacteria in check in our mouths. Since I have an artifical valve, I'll continue to take my premeds. I'm just glad that the medical community is looking at the evidence and not just "it's always been done that way."
Marty
Well-known member
Nancy said:
I started with my brilliant young dentist over 30 years ago. I believe his excellent care has contributed to my longevity. However he has never prescribed prophylactic antibiotics. He said when he was teaching (at one of our better dental schools) he reviewed the entire literature and found prophylactic antibiotics were never shown to prevent infective endocarditis. Some patients had side effects from the antibiotics all the way up to anaphylactic shock.
S
Susan BAV
Kristy - I found your post very interesting; thanks. My cardiologist told me that one of the primary things I could do to keep my new tissue valve in the best condition as long as possible was to take care of my teeth.
LUVMyBirman
Well-known member
What about congenital MVP with reguirg? Seems you would still be required to medicate as usual.
AHA now recommends that prophylactic antibiotic use be reserved for those patients who would have the worsartificial heart valves,t outcomes if IE were contracted, such as patients with artificial heart valves a history of endocarditis, certain serious congenital heart conditions and heart transplant patients who develop a problem with a heart valve.
AHA now recommends that prophylactic antibiotic use be reserved for those patients who would have the worsartificial heart valves,t outcomes if IE were contracted, such as patients with artificial heart valves a history of endocarditis, certain serious congenital heart conditions and heart transplant patients who develop a problem with a heart valve.
Marty
Well-known member
LUVMyBirman said:
If it makes you feel better and you find an antibiotic that doesn't bother you, I say go ahead and take it. The only caveat is- there is no proof it does any good!
Adrienne
Well-known member
Antibiotics before colonoscopy
Antibiotics before colonoscopy
While we are on the subject of prophylactic antibiotics, how many of you who have had colonoscopies have had antibiotics before the procedure? What is the protocol for that?
Antibiotics before colonoscopy
While we are on the subject of prophylactic antibiotics, how many of you who have had colonoscopies have had antibiotics before the procedure? What is the protocol for that?
B
Barbara Stewart
This is certainly something to think about
This is certainly something to think about
I haven't posted much, but I'm alway lurking, seeing how everyone is doing. This caught my eye. Several years ago I had major oral surgery; bone graft, implant and had no antibiotics. At the time I didn't know I had mitral valve prolapse. I had no problems, but now that I had the MRSA infection after my first OHS it makes me reluctant NOT to take prophylactic antibiotics. It is so hard to know the truth of it.
I did not take it for a colonoscopy, but I am going to have foot surgery once I get the OK from my cardio. It will be interesting to hear his opinion on the subject.
Barbara
This is certainly something to think about
I haven't posted much, but I'm alway lurking, seeing how everyone is doing. This caught my eye. Several years ago I had major oral surgery; bone graft, implant and had no antibiotics. At the time I didn't know I had mitral valve prolapse. I had no problems, but now that I had the MRSA infection after my first OHS it makes me reluctant NOT to take prophylactic antibiotics. It is so hard to know the truth of it.
I did not take it for a colonoscopy, but I am going to have foot surgery once I get the OK from my cardio. It will be interesting to hear his opinion on the subject.
Barbara
B
Barbara Stewart
This is certainly something to think about
This is certainly something to think about
I haven't posted much, but I'm alway lurking, seeing how everyone is doing. This caught my eye. Several years ago I had major oral surgery; bone graft, implant and had no antibiotics. At the time I didn't know I had mitral valve prolapse. I had no problems, but now that I had the MRSA infection after my first OHS it makes me reluctant NOT to take prophylactic antibiotics. It is so hard to know the truth of it.
I did not take it for a colonoscopy, but I am going to have foot surgery once I get the OK from my cardio. It will be interesting to hear his opinion on the subject.
Barbara
This is certainly something to think about
I haven't posted much, but I'm alway lurking, seeing how everyone is doing. This caught my eye. Several years ago I had major oral surgery; bone graft, implant and had no antibiotics. At the time I didn't know I had mitral valve prolapse. I had no problems, but now that I had the MRSA infection after my first OHS it makes me reluctant NOT to take prophylactic antibiotics. It is so hard to know the truth of it.
I did not take it for a colonoscopy, but I am going to have foot surgery once I get the OK from my cardio. It will be interesting to hear his opinion on the subject.
Barbara
