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October 15, 1997

Prevention of Bacterial Endocarditis: American Heart Association Recommendations

Author Affiliations

Stony Brook, NY

JAMA. 1997;278(15):1232. doi:10.1001/jama.1997.03550150036022

To the Editor.  —Although the timely and comprehensive update of the AHA recommendations for the prevention of bacterial endocarditis by Dr Dajani and colleagues1 helps clarify several issues, such as the indications for antibiotic prophylaxis in patients with mitral valve prolapse, the article does not address whether antibiotics are indicated for high-risk patients who sustain traumatic lacerations. With more than 12 million such lacerations in the United States annually,2 the issue of whether patients at risk for bacterial endocarditis should receive antibiotics after sustaining a laceration remains important. While not truly prophylactic after the injury has occurred, are antibiotics indicated in this situation?