[Dental extraction and infective endocarditis prophylaxis: current recommendations].
OBJECTIVE
Antibiotic prophylaxis for infective endocarditis is still debated because of unproven efficacy and risk of side effects. French recommendations for infective endocarditis prophylaxis were revised in 2002 and its indications were restricted.


BACKGROUND
Several arguments plead against prophylaxis: the absence of scientific evidence of its efficacy, the very high number of antibiotic doses required to prevent a very small number of endocarditis, the possible failure of prophylaxis even if correctly administered and a lack of compliance with current recommendations. High-risk patients for whom dental extraction is required should receive prophylaxis. For moderate-risk patients, prophylaxis is optional and should be discussed for each case individually.


CONCLUSIONS
Although prophylaxis is discussed, one should focus on prevention measures, such as dental hygiene and education of physicians, dentists and patients.
Lefort
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Service de médecine interne, hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France. aglefort@yahoo.com
D019072:Antibiotic Prophylaxis; D004498:Education, Dental, Continuing; D004502:Education, Medical, Continuing; D004696:Endocarditis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009910:Oral Hygiene; D010353:Patient Education as Topic; D014081:Tooth Extraction / Q000009:adverse effects*; D017211:Treatment Failure