Antibiotic prophylaxis for infective endocarditis (Dental Guidelines)

NHS Highland Cardiology Antibiotic Prophylaxis Guideline for patients at increased risk of Infective Endocarditis

In March 2026, Scottish Dental Clinical Effectiveness Programme (SDCEP) provided detailed information regarding the use of antibiotic prophylaxis for patients undergoing dental procedures who may be at risk of infective endocarditis.

The patients identified in this guidance have an enduring risk of infective endocarditis, with oral hygiene being one of the most significant modifiable risk factors. Dental teams should communicate this link between dental and general health to the patient, and do what they can to motivate and educate patients into the most effective daily plaque reduction strategies. These patients should be prioritised for long term care, and recall intervals adjusted accordingly

The SDCEP guidance can be found here: https://www.antibioticprophylaxis.sdcep.org.uk/

In line with current SDCEP advice, dental teams will make a shared decision on antibiotic prophylaxis with the patient that involves:

• consideration of the IE risk associated with the dental procedure
• the potential benefits and harms of antibiotic prophylaxis
• the patient's oral health status
• the patient's values and preferences
• any information provided by their cardiac team

If dental teams are unable to identify which cardiac pathology or surgery a patient has had, they can contact the patient’s cardiology or cardiac surgery team.

Note: if amoxicillin is being used, staff should be aware of the 2 gram recommended dose being most easily and cost effectively provided through use of 4 x 500mg capsules, rather than the traditional 3 gram sachet.

For glossary of terms see Glossary.