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Prophylaxis against infective endocarditis

Guidance ID NICE 'do not do' recommendation Interventions
CG64 Chlorhexidine mouthwash should not be offered as prophylaxis against infective endocarditis to people at risk of infective endocarditis undergoing dental procedures. chlorhexidine mouthwash
CG64 [NICE] recommends that antibiotic prophylaxis solely to prevent infective endocarditis (IE) should not be given to people at risk of IE undergoing dental and non-dental procedures. The basis to support this recommendation is: There is no consistent association between having an interventional procedure, dental or non-dental, and the development of IE: Regular toothbrushing almost certainly presents a greater risk of IE than a single dental procedure because of repetitive exposure to bacteraemia with oral flora: The clinical effectiveness of antibiotic prophylaxis is not proven: Antibiotic prophylaxis against IE for dental procedures may lead to a greater number of deaths through fatal anaphylaxis than a strategy of no antibiotic prophylaxis, and is not cost effective. antibiotic prophylaxis
CG64 Antibiotic prophylaxis against infective endocarditis is not recommended: For people undergoing dental procedures: For people undergoing non-dental procedures at the following sites : Upper and lower gastrointestinal tract Genitourinary tract; this includes urological, gynaecological and obstetric procedures, and childbirth: Upper and lower respiratory tract; this includes ear, nose and throat procedures and bronchoscopy. antibiotic prophylaxis

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This page was last updated: 28 March 2014

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.