Infective endocarditis prophylaxis in low-risk patients

Pre-procedural antibiotic dosing for dental work in patients without prosthetic valves, prior endocarditis, or cyanotic congenital heart disease. AHA 2021 and ESC 2023 do not include this group in routine prophylaxis.

1 drug

Also known as: Antibiotic prophylaxis for dental procedures, low-risk

Drugs used for this condition

DClarithromycinCase-by-case decision · Macrolide antibioticFor routine prophylaxis of infective endocarditis before dental procedures in low-risk patients, clarithromycin is not prescribed. AHA 2021 restricted prophylaxis indications to patients with prosthetic valves, prior endocarditis, congenital cyanotic heart defects, and cardiac transplant recipients with valvulopathy. Clarithromycin, in cases of beta-lactam allergy, remains a reserve option only in these high-risk groups.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit