####Overall theory is that infectious endocarditis (IE) is
1. Much more likely to be due to random daily bacteremia than for dental / GI / GU procedure
2. Prophylaxis will only prevent a tiny number of IE cases
3. There is significant risk of adverse antibiotic associated events.

####Heart conditions with highest risk of Adverse outcome from IE:
1. Prosthetic valve
2. Previous IE
3. Congenital Heart Disease[^1]
*Unrepaired cyanotic CHD, inculding shunts and conduits
*Completely repaired CHDwith prosthetic material or device in 1st 6mo after repair
*Repaired CHD with residual defects at or adjacent to the site of a patch or prosthetic device
*Cardiac transplant with valvulopathy

[^1]: Abt prophylaxis is not needed for any other form of CHD

Who needs prophylaxis:
1. Dental procedures with gingival manipulation, periapical teeth or oral mucosal perforation
2. Respiratory tract (including T and A)
3. Infected Skin
4. Skin structures
5. Musculoskeletal Tissue

NOT for GI or GU procedures!