Antibiotic Prophylaxis for Dental Patients at Risk for Infection


This best practice offers recommendations regarding antibiotic prophylaxis to minimize or eliminate transient bacteremia in at-risk dental patients undergoing invasive dental procedures. Evidence supporting the efficacy and use of antibiotic prophylaxis is limited among children. Considering the potential to contribute to antibiotic-resistant microorganisms and possible risk of adverse events, prudence is needed when determining whether prophylaxis is necessary. Antibiotic prophylaxis is warranted for some patients with cardiac conditions and compromised immunity when undergoing dental procedures that involve the manipulation of gingival tissue or the periapical region of teeth or perforation of oral mucosa. While recommendations for certain conditions are discussed within the document, consultation with the patient’s physician is recommended for management of other patients potentially at risk due to immune compromise, indwelling vascular catheters or shunts, or implanted devices. Dentists should be familiar with current evidence-based antibiotic prophylaxis recommendations, and specific antibiotic regimens aimed at the microorganisms mainly implicated in infective endocarditis are included. 

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and guidance on antibiotic prophylaxis for dental patients at risk for infection.