24th June 2026

Antimicrobial prophylaxis

Antibiotic prophylaxis is no longer recommended routinely for patients undergoing dental procedures, or for patients undergoing procedures involving the GI tract, genitourinary tract (including gynaecological and obstetric procedures), or the upper and lower respiratory tracts. However, for patients deemed to be at the highest risk for developing IE, antibiotics prophylaxis may be considered for dental procedures, procedures involving the respiratory tract, procedures involving skin and soft tissues, and cardiac surgery involving implantation of prosthetic material. The table below summaries those patients who would be deemed to be at the highest risk of developing IE.

Patients considered to be at high risk are those with the following conditions:

• acquired valve disease (stenosis or regurgitation);
• hypertrophic cardiomyopathy;
• previous IE,
• structural congenital heart disease (excluding isolated ASD, fully repaired VSD or PDA, and closure devices that are fully incorporated into the endothelium)
• patients with a prosthetic valve.