Choosing Wisely Recommendations
Avoid prophylactic antibiotics for the treatment of mitral valve prolapse.
Rationale and Comments
Antibiotic prophylaxis is no longer indicated in patients with mitral valve prolapse for prevention of infective endocarditis. The risk of antibiotic-associated adverse effects exceeds the benefit (if any) from prophylactic antibiotic therapy. Limited use of prophylaxis will likely reduce the unwanted selection of antibiotic-resistant strains and their unintended consequences such as Clostridium difficile–associated colitis.
Sponsoring Organizations
- Infectious Diseases Society of America
Sources
Disciplines
- Cardiovascular
- Infectious disease
References
- Nishimura RA, Carabello BA, Faxon DP, Freed MD, Lytle BW, O’Gara PT, O’Rourke RA, Shah PM. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(8):676-85.
- Gopalakrishnan PP, Shukla SK, Tak T. Infective endocarditis rationale for revised guidelines for antibiotic prophylaxis. Clin Med Res. 2009;7(3):63–8.
