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Pharmacology · single question

A patient with a prosthetic heart valve needs dental treatment that may cause bacteremia. Does this patient require antibiotic prophylaxis?

  1. Yes — prosthetic heart valves are a high-risk cardiac condition requiring prophylaxis
  2. No — only high-risk patients need prophylaxis
  3. Only if the patient has had prior endocarditis
  4. Only for surgical procedures, not cleanings
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Correct answer: A. Yes — prosthetic heart valves are a high-risk cardiac condition requiring prophylaxis

  • A. Correct. According to the 2007 AHA guidelines, prosthetic heart valves (mechanical or biological) are one of the HIGH-RISK cardiac conditions that require antibiotic prophylaxis before dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. Amoxicillin 2g (adults) 1 hour before is standard.
  • B. Prosthetic heart valve patients ARE high-risk — prophylaxis is indicated.
  • C. Prior endocarditis is also a high-risk condition, but prosthetic valves independently require prophylaxis.
  • D. Cleanings that involve gingival manipulation also require prophylaxis in prosthetic valve patients.

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