Endocarditis Prophylaxis NOT Recommended

Dental or Surgical Procedures for which IE Prophylaxis is NOT Recommended:


Dental/oral: Routine anesthetic injections through noninfected tissue, taking of dental x-rays, placement of removable prosthodontic or orthodontic appliances, adjustment of orthodontic appliances, placement of orthodontic brackets, shedding of primary teeth, bleeding from trauma to lips or oral mucosa.


Respiratory tract: Tympanostomy tube insertion. Endotracheal intubation. Surgical procedures that do not involve incision or biopsy of respiratory mucosa. Bronchoscopy without incision of respiratory tract mucosa.


GI & GU: Administration of antibiotics solely to prevent endocarditis is no longer recommended for patients undergoing a GU (including vaginal delivery and hysterectomy) or GI tract procedure. For select procedures (e.g. hepatobiliary, complicated urinary tract procedures), standard surgical prophylaxis may need to be modified to include enterococcal coverage.


Other: Cardiac catheterization. Implantation of cardiac pacemakers, defibrillators, stents. Incision/biopsy of surgically scrubbed skin. Circumcision. Ear/body piercing or tattooing.