Clinical Reference Systems: Pediatric Advisor 10.0
Prevention of Bacterial Endocarditis Using Antibiotics
What is bacterial endocarditis?
Bacterial endocarditis is a disease of the heart valves or
the inner lining of the heart. Bacteria lodge on these
structures and begin to grow. Some children with heart
defects or heart diseases (such as rheumatic fever) are more
likely to get bacterial endocarditis. This condition can
sometimes be prevented by taking antibiotic medicine before
an operation or other medical or dental procedure.
Your child's doctor has determined that your child should
receive antibiotics in the future to reduce the risk of
bacterial endocarditis. Always consult your doctor before
any upcoming surgery or trip to the dentist about the need
When should my child take antibiotics?
The most common reason for needing antibiotics for
prevention of bacterial endocarditis is when your child has
a dental procedure. Your child should receive antibiotics
before dental procedures where bleeding is expected, such
- cleaning teeth
- cutting tissue
- probing the gums
- reimplanting a live or a false tooth
- placing orthodontic bands.
Dental procedures where bleeding is not expected do not
require taking antibiotics before hand. These include:
- filling cavities
- injecting of anesthetics (painkillers) for dental
- adjusting of orthodontic devices that are already in
- getting fluoride treatments.
Antibiotic treatment is also not necessary when your child
loses his or her baby teeth.
Other situations in which your child should receive
antibiotics may include:
- Some operations or procedures that involve the
respiratory system including the nose, mouth, and upper
part of the airway. They may include removing tonsils
or adenoids, or having a rigid bronchoscopy (a procedure
in which a scope is inserted into the large airways).
- Some operations or procedures that involve the stomach
and intestinal system including the esophagus (the
swallowing tube) and the bile ducts.
- Some operations or procedures that involve the genitals
or urinary system including the bladder and the urethra
(the tube that urine goes through).
Some procedures or events involving the respiratory,
gastrointestinal, and genitourinary systems do not require
- putting a breathing tube into the airway
- doing a flexible bronchoscopy
- putting in ear tubes
The decision to use antibiotics is sometimes a complex one.
Your doctor(s) may consider many factors before deciding
whether to recommend antibiotics for your child. Always
consult your doctor if you have any questions about the need
Be certain to tell your doctor if your child has any
allergies to any antibiotics before they are prescribed.