"IE Prophylaxis"


As I promised Wuchereria today, I will try to post a favourite PACES question i.e "Does this patient need IE prophylaxis?". The fellows just like to ask this question for CVS station after you listen to the murmurs. So, what is the answer?

1. MUST on IE prophylaxis

• Prosthetic heart valves
• IE patients
• Complex cyanotic congenital heart diseases

2. SHOULD on IE prophylaxis

• Congenital cardiac malformations like VSD (with the exception of isolated secundum atrial septal defects)
• CRHD like MS, MR, AS, AR
• Hypertrophic cardiomyopathy
• Mitral valve prolapse

Secondly, they will ask what procedures need IE prophylaxis? For PACES, just remember all dental procedures need IE prophylaxis. (In fact, NOT all of them need one).

Other procedures will includes:

1. Respiratory

• Tonsillectomy
• Rigid bronchoscopy

2. GI

• ERCP
• Operation that involve intestinal mucosa
• Biliary surgery
• Esophageal stricture dilatation
• Sclerotherapy for esophageal varices

3. Genitourinary

• Cystoscopy
• Prostate surgery like TURP
• Urethral dilatation