. 2009 Sep;7(3):63–68. doi: 10.3121/cmr.2009.848

Table 4.

NICE guidance for infective endocarditis prophylaxis.

Cardiac conditions at high risk for infective endocarditis:

Acquired valvular heart disease with stenosis or regurgitation
Valve replacement
Structural congenital heart disease, including surgically corrected or palliated structural conditions, but excluding isolated atrial septal defect, fully repaired ventricular septal defect or fully repaired patent ductus arteriosus, and closure devices that are judged to be endothelialized
Previous infective endocarditis
Hypertrophic cardiomyopathy

Antibiotic prophylaxis is not recommended:

For people undergoing dental procedures
For people undergoing non-dental procedures at these sites (upper and lower gastrointestinal; genitourinary tracturological, gynecological and obstetric procedures, and childbirth; upper and lower respiratory tract – includes ear, nose and throat procedures and bronchoscopy)

Chlorhexidine mouthwash is not recommended for infective endocarditis prophylaxis for dental procedures.

Infections in patients at risk for infective endocarditis should be promptly treated to reduce risk of infective endocarditis developing. Antibiotic therapy used for gastrointestinal or genitourinary procedures at a site with suspected infection in patients at risk of infective endocarditis, should cover organisms causing infective endocarditis.

Patients should be educated on benefits and risks of antibiotic prophylaxis, recommendations against antibiotic prophylaxis, importance of oral hygiene, symptoms of infective endocarditis and risks of invasive procedures including non-medical procedures like body piercing and tattooing.