Which statement describes prophylaxis for patients with prior infective endocarditis?

• A. Prophylaxis is never indicated
• B. Prophylaxis is always indicated for all dental procedures
• C. Prophylaxis may be indicated for dental procedures in patients with prior IE
• D. Prophylaxis is indicated only for cardiac transplant patients

Answer: (C)

Antibiotic prophylaxis around dental work is about reducing the chance that oral bacteria entering the bloodstream will seed heart tissue in people with certain heart conditions. For someone who has had infective endocarditis, the risk of a recurrent infection is higher, so guidelines support the use of prophylaxis in dental procedures that involve manipulation of the gingival tissue or perforation of the oral mucosa. This means it’s not required for every dental procedure, and it’s not limited only to transplant patients or never indicated. The best statement is that prophylaxis may be indicated for dental procedures in patients with prior IE. In practice, if prophylaxis is chosen, a typical option is amoxicillin given before the procedure (with alternatives for penicillin allergy), and the decision should align with current guidelines and the patient’s cardiologist.