Table 2

Summary of organisational recommendations for prophylaxis for dental procedures with risk of gingival or mucosal trauma in patients with the highest incidence of IE and/or highest risk of adverse outcome from IE

Organisation (reference #)Prophylaxis recommended*Cardiac conditions
AHA15Amoxicillin 2 g orally 30–60 min before the procedureProsthetic cardiac valve or prosthetic material used for cardiac valve repair
Previous IE
Congenital heart disease (CHD)

  • – Unrepaired cyanotic CHD, including palliative shunts and conduits

  • – Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure

  • – Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialisation)

Cardiac transplantation recipients who develop cardiac valvulopathy 
ESC17Amoxicillin or ampicillin 2 g orally or intravenously 30–60 min before the procedureProsthetic valve or prosthetic material used for cardiac valve repair
Previous IE
CHD, in particular, complex cyanotic heart disease and postoperative palliative shunts, conduits or other prostheses. After surgical repair with no residual defects, prophylaxis for the first 6 months after the procedure until endothelialisation of the prosthetic material occurs.
French183 g amoxicillin orally in the hour before the procedureValvar prostheses (mechanical, homograft or bioprosthetic)
Non-operated cyanotic
CHD and pulmonary–systemic shunts
Previous IE
NICE19NoneNone

  • *First choice, adult doses listed. For paediatric doses or alternative medications, see references.

  • AHA, American Heart Association; IE, infective endocarditis; NICE, National Institute for Health and Care Excellence.