Antibiotic therapy is no longer necessary for a patient undergoing a urologic or gastrointestinal procedure.
Highest risk cardiac patients include:
(1) history of infectious endocarditis
(2) cardiac valve containing prosthetic material (entire valve or from a repair)
(3) cardiac transplant patient with an acquired valvulopathy
(4) congenital heart disease with one or more of the following:
(4a) cyanotic disease not repaired, with or without palliative conduits or shunts
(4b) completely repaired AND no residual defect AND less than 6 months since the procedure
(4c) repaired AND residual defect at site
(4d) repaired AND residual defect adjacent to a prosthetic patch or prosthetic device
where:
• A residual defect prevents adequate endothelialization over a patch or device.
• Adequate endothelialization takes about 6 months after a complete repair.
Highest risk dental procedures include:
(1) manipulation of the gingival tissue
(2) manipulation of the periapical region of a tooth
(3) any perforation of the oral mucosa (except in the list below)
Manipulations may include:
(1) cleaning
(2) biopsying
(3) removing a suture
(4) extracting a diseased tooth
The highest risk dental procedures do not include:
(1) routine injection of a local anesthetic through noninfected tissue
(2) taking dental radiographs
(3) placing a removable orthodontic or prosthodontic appliance
(4) adjusting an orthodontic appliance
(5) placing orthodontic brackets
(6) shedding a deciduous tooth (in a child)
(7) bleeding from trauma to the oral mucosa or lips
