Transcript New Guidelines from AHA regarding infective edocarditis

Miriam Ika, Jessica Hilton, Emily Lloyd,
Michelle Fambrough, Francesca Mustari,
Lori Brannin, Chelsa Bringhurst, Kevin
Echols



For decades, the decades American Heart Association
recommended that patients with certain heart conditions
take antibiotics shortly before dental treatment.
Antibiotics were taken with a belief that they would
prevent infective endocarditis (IE), previously referred to
as bacterial endocarditis.
In April 2007, the AHA published new guidelines with
good news: the AHA recommends that most of these
patients no longer need short-term antibiotics as a
preventive measure before their dental treatment.



American Dental Association
The Infectious Diseases Society of America
Pediatric Infectious Diseases Society

All groups participated in the development of the new
guidelines and it has approved the new standards.

The guidelines are based on a growing body of
scientific evidence that shows the risks of taking
preventive antibiotics are greater than the
benefits for most patients.



Adverse reactions to antibiotics to mild to
potentially severe cases.
Inappropriate use of antibiotics can also lead to
the development of drug-resistant bacteria.
Unnecessary use of antibiotics could cause
allergic reactions and dangerous antibiotic
resistance.



Scientists found no compelling evidence that taking
antibiotics prior to a dental procedure prevents IE in
patients who are at risk of developing a heart infection.
Their hearts already are often exposed to bacteria from
the mouth, which can enter their bloodstream during
basic activities such as brushing of flossing.
The new guidelines are based on a comprehensive review
of published studies that suggest IE is more likely to
occur as a result of everyday activities then from a dental
procedure.

Patients include those with:



Artificial heart valves
A history of having had IE
Certain specific, serious congenital heart conditions
including :
 Unrepaired or incompletely repaired cyanotic congenital
heart disease, including those with palliative shunts and
conduits.





a completely repaired congenital heart defect with
prosthetic material or device, whether placed by surgery
or by catheter interventions, during the first six months
after the procedure.
Any repaired congenital heart defect with residual defect
at the site or adjacent to the site of a prosthetic patch are
prosthetic device.
A cardiac transplant which develops a problem in a heart
valve.
Hypertrophic cardiomyopathy
Heart valves damaged by conditions such as rheumatic
fever.



Gram Positive
Most resistant of all non-spore forming bacteria,
which also lack flagella
Enzymes
Coagulase –causes clotting
 Hyaluronidase-digest hyaluronic (cement between cells)
 Penicillinase and other enzymes deactivate drugs, by
breaking down the bata-lactam ring
