American Board of Family Medicine (ABFM) Practice Exam 2026 - Free ABFM Practice Questions and Study Guide

Prophylactic antibiotics are indicated to prevent bacterial endocarditis primarily in individuals who have structural heart problems that increase their risk of infection from dental or gastrointestinal procedures. This includes patients with prosthetic heart valves.

The rationale behind this is that prosthetic valves are foreign objects within the body, making them a potential site for bacteria to adhere to and cause infection if introduced into the bloodstream during procedures where bleeding could occur, such as dental cleanings or certain gastrointestinal interventions.

Patients with a history of mitral valve prolapse, a heart murmur, or palpitations do not universally require antibiotic prophylaxis. While these conditions may be associated with an increased risk of endocarditis in some cases, current guidelines specifically emphasize the need for prophylaxis primarily in individuals with prosthetic heart valves, previous infective endocarditis, or certain congenital heart defects. Therefore, the focus on assessing the need for antibiotic prophylaxis hinges on the presence of prosthetic valves as a significant risk factor.