Family Nurse Practitioner Exam

What is the recommended prophylactic treatment for a patient with a history of mitral valve prolapse before dental surgery?

1. Amoxicillin a half hour before and 2 hours after the procedure

2. Amoxicillin 1 hour before the procedure

3. Amoxicillin 1 hour before and 3 hours after the procedure

4. Prophylaxis is not recommended for this patient

The correct answer is: Prophylaxis is not recommended for this patient

The recommended approach for a patient with a history of mitral valve prolapse prior to dental surgery reflects updated guidelines in cardiovascular health. Prophylactic antibiotic treatment is primarily aimed at those with specific high-risk heart conditions to prevent infective endocarditis during bacteremia that can occur with dental procedures. For individuals with mitral valve prolapse who do not exhibit any accompanying risk factors such as a history of complications (i.e., previous endocarditis, prosthetic valves, etc.), the current recommendations no longer advocate for routine antibiotic prophylaxis. This reflects a significant shift in practice, as prior guidelines suggested prophylaxis for all patients with mitral valve prolapse, but current evidence indicates that the risk of endocarditis in this population is low. Consequently, for a patient with isolated mitral valve prolapse undergoing dental surgery and without additional risk, prophylaxis is not recommended, thereby supporting the chosen answer that asserts antibiotic prophylaxis is unnecessary in this context. This change emphasizes the importance of evaluating individual patient risk rather than applying a blanket approach to prophylaxis.