Box 1. Summary of guidance
  • People at high risk: replacement heart valves or┬áprior endocarditis

  • People at moderate risk: native valve disease

  • High-risk dental procedure: extractions, root canal treatment, dental scaling and other procedures involving manipulation of the gums

  • Antibiotic prophylaxis: indicated for people at high-risk having high-risk dental procedures. Record details of consent process in the dental notes. Use amoxicillin 3 g or clindamicin 600 mg orally 1 hour before

  • Other advice: dental surveillance every 6 months (high-risk people) or annually (medium-risk people), avoid tattoos and intravenous drug use

  • Warning: consider infective endocarditis with persistent fever or night sweats especially with systemic symptoms. Take at least two sets of blood cultures before starting an antibiotic course.