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Infective Endocarditis Prophylaxis — MFDS Part 1 MCQ

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ModeratePharmacologyInfective Endocarditis ProphylaxisMFDS Part 1

Under NICE CG64, interpreted with current SDCEP implementation advice, which statement best describes the UK approach to antibiotic prophylaxis against infective endocarditis for patients undergoing dental procedures?

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Correct answer: AIt is not routine; cardiac risk, the procedure and patient preferences should be assessed

NICE CG64 states that antibiotic prophylaxis against infective endocarditis is not routinely recommended for dental procedures. This does not mean that it must never be provided. Current UK-endorsed SDCEP advice requires assessment of the cardiac risk category and proposed procedure, with shared decision-making. For high-risk patients, prophylaxis should be offered before extractions and oral surgery and considered for procedures involving gingival or periapical manipulation. It is generally not recommended for moderate-risk patients. Therefore, it is not automatically indicated for every increased-risk patient, every extraction or every dental procedure. Clindamycin is not the routine regimen for penicillin allergy in current SDCEP advice.

Reference: National Institute for Health and Care Excellence. CG64: Prophylaxis against infective endocarditis, recommendation 1.1.3. Last updated 8 July 2016; dental implementation advice clarified December 2024. https://www.nice.org.uk/guidance/cg64/chapter/recommendations