Recommendations for the prevention of infective endocarditis and prosthetic joint infection in high-risk patients undergoing invasive dental procedures

Infective endocarditis (IE) is a rare but severe condition resulting from bacteremia. It is caused by microorganisms that enter the bloodstream and reach the endocardium, one or more heart valves, or blood vessels in patients at high risk for its development. Prosthetic joint infection is a serious complication following knee or hip arthroplasty and is the major cause of its failure. Following invasive medical and dental procedures, bacteremia can cause complications in high-risk patients. The goal of antibiotic prophylaxis (AP) is to limit or eliminate transient bacteremia resulting from invasive procedures. This review aims to summarize and discuss the global recommendations of the cardiologic and orthopedic societies for antibiotic prophylaxis in invasive dental procedures concerning the growing risk of antimicrobial resistance and its severe effects on public health. The data search was performed using the selected keywords in PubMed, Scopus, Web of Science, and Google Scholar databases. After careful study selection, 30 articles were included in this review. The use of AP is only indicated in patients at high risk of developing IE who undergo invasive dental treatment. The drug of choice for AP in patients at risk is amoxicillin/clavulanic acid. In allergic-to-penicillin patients, cephalosporins (not used in patients reporting immediate allergic reactions), clarithromycin, azithromycin, and doxycycline can be used. Clindamycin is no longer recommended for the prophylaxis of IE. Routine use of antibiotics for dental procedures following total joint replacement is currently not recommended.