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American Heart Association New Guidelines

As the mother of two children with congenital heart defects, I pay extra close attention to changes with the American Heart Association (AHA) guidelines. At my children’s last cardiology visit, our cardiologist informed me of a huge change the AHA has made. Many (not all) cardiac patients have been advised until recently to take a special antibiotic prior to dental work or surgery of any kind due to the risk of endocarditis. Endocarditis is an infection in the heart’s valves or lining and is spread through the bloodstream. This is a very serious and life-threatening infection. Dental work or medical procedures are a very common way this bacteria is spread. Unfortunately, there hasn’t been enough research to prove that the prophylaxis antibiotic is effective in preventing this infection and antibiotics have their own set of risks. The AHA has now changed their guidelines and does not recommend prophylaxis antibiotics prior to procedures except for a very small number of cardiac patients.

My children’s cardiology practice is saying “no thank you” to the AHA’s new guidelines. While unnecessary use of antibiotics can cause allergic reactions and antibiotic resistance, some people feel that a one time dose of antibiotic prior to a procedure does not contribute to the antibiotic resistance issue. It is also feared that this is the AHA’s way of getting the necessary research done to know for sure whether the antibiotic is effective in stopping the spread of endocarditis. It was impossible to ethical perform research studies under the previous guidelines.

This is a huge controversy among many families and the medical community and a very important issue. I am curious to see how this all plays out. I am curious to see how many cardiologists agree with the AHA and how many disagree and continue to prescribe antibiotics for their patients prior to procedures. My children will continue to receive the antibiotic prior to procedures and dental work until I and their cardiologist feel more confident in this new change, however please check with your cardiologist to see what precautions from endocarditis he or she recommends.

The AHA’s current information and guidelines on endocarditis can be found here.

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