Contribution to the Prophylaxis of Infec-tious Endocarditis during Dental Treatment

Overview

In patients with a high or medium risk of infectious endocarditis it is importantto respect the colonization of the oral cavity by a varied bacterial flora and the ensuing risk ofbacteraemia. During every dental treatment of such patients mechanical cleaning and localdisinfection of the mouth is essential (e.g. with a 0.12% chlorohexidine solution). Before aninvasive dental procedure antibiotic prophylaxis must be administered. With regard to themixed aerobic-anaerobic microbial flora in the oral cavity we should always assume the possiblepresence of Actinobacillus actinomycetemcommitans (in particular in concurrent periodontitis)and anaerobic organisms from the Bacteroides group. These microorganisms have a minimalsensitivity to antibiotic prophylaxis recommended by the American Heart Association in 1997.The authors recommend the use of effective antibiotic prophylaxis: amoxicillin combined withmetronidazol or an ofloxacin preparation.

Key words:
Actinobacillus actinomycetemcommitans – Bacteroides spp. – amoxicillin –metronidazol – ofloxacin – bacterial endocarditis – antibiotic prophylaxis