In past years antibiotic prophylaxis was recommended for certain disease or developmental states, such as mitral valve prolapse and heart murmurs, to prevent infective endocarditis, or bacterial infection/colonization of heart valves. After extensive research, the American Heart Association has since changed these recommendations (in 2007) to include prophylaxis only for patients with the following conditions:

  • artificial heart valves
  • a history of infective endocarditis
  • a cardiac transplant that develops a heart valve problem
  • the following congenital (present from birth) heart conditions:*
  1. unrepaired cyanotic congenital heart disease, including palliative shunts and conduits
  2. completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure
  3. repaired congenital heart disease with residual defects at the site or adjacent to the site of a 
prosthetic patch or prosthetic device

In short, Antibiotic prophylaxis recommendations exist for two groups of patients:

  • those with heart conditions that may predispose them to infective endocarditis (please see above).
  • those who have a total joint replacement and may be at risk for developing hematogenous infections at the site of the prosthetic (please see Hip/Joint replacement section).

Patients who took prophylactic antibiotics in the past but no longer need them include those with:

  • mitral valve prolapse
  • rheumatic heart disease
  • bicuspid valve disease
  • calcified aortic stenosis:
  • congenital (present from birth) heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy