MVP & Antibiotics

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In a message dated 6/11/00 11:00:29 AM Pacific Daylight Time,

tackylady1@... writes:

<< JOHN..SINCE YOU AREN'T REALLY SURE ABOUT THE DENTIST MEDS BEFORE DENTAL

WORK, SHOULDN'T MOST PEOPLE TAKE THEM ANYWAY, JUST IN CASE YOU ARE WRONG? BETT

ER SAFE THAN SORRY..NANCY>>

Hi ,

You are right. I should have researched the issue before passing out

some bad information.

I started looking into the situation and added some studies to the MVP

page on iThyroid.com. There is a condition called bacterial endocarditis

which is an infection of the heart. According to a study called " Prevention

of bacterial endocarditis: recommendations by the American Heart

Association " , these are the new recommendations: " CONCLUSIONS: Major changes

in the updated recommendations include the following: (1) emphasis that most

cases of endocarditis are not attributable to an invasive procedure; (2)

cardiac conditions are stratified into high-, moderate- and negligible-risk

categories based on potential outcome if endocarditis develops; (3)

procedures that may cause bacteremia and for which prophylaxis is recommended

are more clearly specified; (4) an algorithm was developed to more clearly

define when prophylaxis is recommended for patients with mitral valve

prolapse; (5) for oral or dental procedures the initial amoxicillin dose is

reduced to 2 g, a follow-up antibiotic dose is no longer recommended,

erythromycin is no longer recommended for penicillin-allergic individuals,

but clindamycin and other alternatives are offered.

From reading through the studies it seems that some people are now

questioning the need for antibiotics before dental surgery. The above study

states that the probability of getting bacterial endocarditis from a dental

procedure is very small, but the American Heart Association still recommends

the preoperative use of antibiotics for certain predisposed persons.

Apparently all persons with MVP are not at risk but so far I haven't been

able to determine which MVP patients are at risk.

The reason for the controversy is that antibiotic use is not without

risk. Repeated use of antibiotics can give rise to antibiotic-resistant

strains of bacteria and antibiotics kill the body's intestinal bacteria which

are needed for the production of certain vitamins. There are some scientists

who feel that antibiotics cause cancer. While taking antibiotics before

every dental procedure might seem to be good insurance, there are risks and

costs associated with antibiotic use and it should be kept to a minimum.

If I find additional information on MVP I'll post it on the MVP page, but

in the meantime if your doctor feels that you should take antibiotics before

dental procedures, then take them. You might ask your doctor which type of

MVP patients need to take antibiotics. If you are prone to infections, I

think it's a good idea to take them.