Observations in the study of adult patients without IV drug use:
(1) underlying valvular abnormalities are a risk factor for endocarditis
(2) transient bacteremia occurs without dental manipulation
(3) patients who developed endocarditis were no more likely to have undergone dental treatment than matched controls without endocarditis
(4) few cases of endocarditis are prevented by following the current prophylactic recommendations
(5) endocarditis caused by dental treatment is too rare to justify the routine use of antibiotic prophylaxis in all patients
Children were not included in the study and no recommendations were made for this population.
Durack lists the following as high risk conditions in adults, with antibiotic prophylaxis required when one or more are present:
(1) dental extractions
(2) gingival surgery, including implant placement
(3) presence of prosthetic cardiac valve
(4) history of previous endocarditis
