About antibiotic prophylaxis
Antibiotic prophylaxis is the use of antibiotics before surgery or a dental procedure to prevent a bacterial infection. This practice isn’t as widespread as it was even 10 years ago. This is due to:
- the increase in the resistance of bacteria to antibiotics
- the change in bacteria that cause infections
- improvements in technology that can detect infections
However, antibiotic prophylaxis is still used in people who have certain risk factors for bacterial infection. Professional guidelines recommend using antibiotics before procedures that have a high risk of bacterial infection. These include:
- surgeries for head and neck cancer
- gastrointestinal surgeries
- cesarean delivery
- surgeries for implanting a device, such as a pacemaker or defibrillator
- cardiac procedures such as coronary artery bypass grafts, valve replacements, and heart replacements
The most common antibiotics used before surgeries are cephalosporins, such as cefazolin and cefuroxime. Your doctor may prescribe vancomycin if you are allergic to cephalosporins. They may also prescribe it if antibiotic resistance is a problem.
For dental procedures, your doctor will likely prescribe amoxicillin or ampicillin.
People who may need antibiotic prophylaxis usually have factors that put them at higher risk of infection during surgery than the general population. These factors include:
- very young or very old age
- poor nutrition
- smoking, including a history of smoking
- existing infection, even at a different site from where the surgery will be done
- recent surgery
- extended hospital stay before the procedure
- certain congenital heart conditions, meaning ones that have existed since birth
Antibiotic prophylaxis for dental procedures may be appropriate for people who have:
- compromised immune systems
- artificial heart valves
- histories of infection in the heart valves or the lining of the heart, known as infective endocarditis
- heart transplants that have led to problems with one of the heart valves
The drug forms and administration usually depend on the type of procedure you will have.
Before surgery, a healthcare provider usually gives antibiotics through a tube that they have inserted into one of your veins. Or they may prescribe a pill. You usually take the pill about 20 minutes to an hour before your procedure. If the surgery involves your eyes, your doctor may give you drops or a paste. They will apply these directly to your eyes.
Before dental procedures, your doctor will most likely prescribe pills that you take by mouth. If you forget to fill your prescription or to take your pills before your appointment, your dentist may give you antibiotics during or after the procedure.
Antibiotic prophylaxis is effective, but you should still watch for symptoms of infection after your procedure. These include fever as well as pain, tenderness, pus, or an abscess (pus-filled lump) near the surgical site. Untreated infections can lead to longer recovery times. In very rare cases, they can cause death. Call your doctor right away if you have any of these symptoms.