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Prevention of Bacterial Endocarditis with Antibiotics


What is bacterial endocarditis?

Bacterial endocarditis is an infection of the lining inside of the heart muscle and valves. Bacteria attach to the lining, usually on the heart valves. They grow there and can damage the valves. Children with some kinds of heart defects or heart diseases (such as rheumatic fever) are more likely to get this infection. Children with other heart defects are better off not taking antibiotic medicines before dental work.

When should my child take antibiotics?

Dental Work:

Taking antibiotics to prevent or reduce bacterial endocarditis may not provide a great benefit. However, antibiotics are still recommended before work that may cause bleeding. This kind of dental work is more likely to result in bacteria in the blood stream. Antibiotics are advised before dental work that may cut mouth tissue or gums, such as:

  • cleaning teeth
  • cutting tissue
  • probing the gums
  • putting a tooth back in after it was knocked out

Your child does not need to take the medicine if there will be no bleeding. Dental work that usually does not cause bleeding includes:

  • filling cavities
  • getting a shot to numb the mouth
  • adjusting braces
  • getting fluoride treatments.

Antibiotics are not needed when your child loses baby teeth.

Medical Procedures:

Your child should take antibiotics before surgeries and procedures that involve:

  • The nose, mouth, and upper part of the airway (such as removing tonsils).
  • The stomach and intestines. This includes the esophagus (the swallowing tube), bile ducts, and colon.
  • The genitals or urinary system. This includes the bladder and the urethra (the tube that urine goes through).

Your child does not need antibiotics for procedures such as:

  • putting in ear tubes
  • circumcision.

Your healthcare provider can decide if your child needs antibiotics. Always talk to your provider if you have any questions.

Be sure to tell your provider if your child is allergic to any medicines.


Written by Robert Brayden, MD, Professor of Pediatrics, University of Colorado School of Medicine.
Published by RelayHealth.
Last modified: 2010-10-14
Last reviewed: 2010-10-13

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a health care professional.

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