All...as the "difficult patient" I tend to argue on the less is more side of things. The American Academy of Cardiologists recommend the following regimen for those with artificial (not your own) valves. For those who can take penicillin, 2 grams of amoxicillin, one hour before appointment is sufficient (actually anywhere from one hour prior up to two hours after). If you can't take penicillin, then clindamycin (sp) is recommended. Same dosage and schedule I think. I HATE taking any antibiotics...I believe that for the most part, unless our own immune system is compromised, it's best to let our bodies fight off any "bugs". I take these antibiotics before my dental cleanings because my dentist won't work on me otherwise.
These latest guidelines came about because the studies were showing that the cases of endocarditis were NOT reduced by premedication. However, to cover their own carcasses, the AAC stopped short of recommending that premedication protocols be stopped. There is just as much chance of you releasing harmful bacteria into your bloodstream by routine brushing and flossing, and no one is suggesting that you have a daily regimen of antibiotics for that, nor are they suggesting that you stop brushing and flossing!
All of us must make our own decisions on this issue. I'm a believer that sooner than later, many of us are going to encounter some form of resistant bacteria, and the antibiotics should be left to fight those.
