Antibiotic prophylaxis for medical and dental procedures. A look at AHA guidelines and controversial issues.

Are prophylactic antibiotics really needed to prevent endocarditis and prosthetic joint infection when patients at risk undergo medical and dental procedures likely to cause bacteremia? Although animal studies seem to support such prophylaxis, clinical trials in humans are lacking, and some authorities believe it is unethical to give antibiotics without more evidence of benefit. Dr Uyemura examines the problem in this article.