ANTIBIOTIC PROPHYLAXIS in a time of antibiotic resistance 

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For a portion of the patient population, antibiotic prophylaxis is an extra step required before particular dental procedures.  For most, a healthy immune system prevents bacteria that may enter the bloodstream from causing harm, also known as, bacteremia. For some, the bacteria may result in an infection elsewhere in the body. Thus, the necessity of pre-medication results. 

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Who is this typically recommended for? Traditionally, those with specific heart conditions, such as: artificial valves, a history of infective endocarditis (infection of the heart), heart transplant patients, and those with congenital issues. Additionally, antibiotic prophylaxis has been recommended for those with orthopedic implants and artificial joints. 

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Though the rationale is to reduce or eliminate risk of acquiring an infection of the heart or prosthesis that may  potentially result from invasive dental procedures, antibiotic prophylaxis and associated guidelines have evolved over the last decade. This is due to increasingly prevalent worldwide concerns regarding antimicrobial resistance.  Though there has been an overall reduction in the use of antibiotics, different countries have varied in their recommendations and restrictions. 

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Ongoing research will only improve our understanding of the effectiveness, and where to find the balance between use and misuse. with antibiotic resistance in mind.