Antibiotics for Aortic Insufficiency

[sandra kimmel]

I have aortic insufficiency, and am very concerned because I have been prescribed antibiotics for different procedures at least once a month since May.  I had dental work twice, a colonoscopy, and a gynecological procedure during which time I had to have the prophylactic antiobiotic doses before the procedures.  Then I had a dog bite and was on antibiotics for ten days.  I have an upcoming gynecological procedure in a couple of weeks for which I will have to again do the prophylactic dose.

I am concerned that bacteria will become resistant to antiobiotics and in the future when I have valve surgery the antiobiotics will not work if my valve would become infected.

What are the chances of the new valve becoming infected and antibiotics not working?  What are the chances of my old valve becoming effective and antibiotics not working?  Could all of these antiobiotics damage my kidneys?

I was hardly ever on antiobiotics in my life and now it seems that I'm on them monthly.

Lastly, my gynecologist was upset with my cardiologist for wanting me on antibiotics for the biopsy that he did.  He said according to the AHA I do not need it for a cervical biopsy.  My cardiologist insisted that I do need it.  I was caught in the middle.  My gynecologist said it's not good to be on antiobiotics so often - then he mumbled something about my kidneys.

Should I be worried about these drugs not working someday when I may really need them?

I know I asked quite a few questions, but I really need to get these settled in my mind, because every time I have to take an antibiotic for a procedure, I really worry about this.

Thank you so much for your medical expertise.

[CCF CARDIO MD JMF]

Dear Sandy,  
It is important to be on antibiotics to protect your valve.  There is considerable debate on their use in  different procedures.

You should check out the AHA statement on antibiotic prophylaxis on the american heart assn.  website ( www.amhrt.org.....look under AHA statements and you can print out the entire guideline.  This will help you to understand the role of antibiotics and the pros and cons of pretreatment.

[lisa]

I am in the same boat, and feel that it is fairly safe.  Even though you may build up a tolerance for one antibiotic, there are many others out there.  After having rheumatic fever, I was on a therapeutic dose of penicillin for about 15 years.  I would still get infections occasionally, and the doctor would put me on a stronger antibiotic for a short time.  I also had to take stronger antibiotics before dental work.  I was told that any procedure that might have an open cut required prophylactic use, and I would think a cervical biopsy should be included.  On the other hand, I had an acquaintance who had a damaged valve and did not take the prescribed antibiotics in conjunction with a root canal.  That person got an infection and died.  So, caution sure beats the alternative - DEAD!

[Response to Lisa]

Thanks for the input.  I think what I'm concerned about is if I
really don't have to take the antibiotic for certain procedures, such as the cervical biopsy, I would rather not take it, because
there are other procedures such as dental work, etc. that I know I absolutely need to take it.

In view of the fact that my gyne thought it was ridiculous that I had to take it for the biopsy and my cardiologist said it was absolutely necessary, I don't know what to think!  My gyne feels my cardiologist is being overly cautious and that too many antibiotics are just not good, only when absolutely necessary, and he agrees that with more invasive procedures, it would be necessary.

So, I'm caught in the middle, and I'm confused!

[CCF CARDIO MD JMF]

Dear Sandy,  
It is important to be on antibiotics to protect your valve.  There is considerable debate on their use in  different procedures.

You should check out the AHA statement on antibiotic prophylaxis on the american heart assn.  website ( www.amhrt.org.....look under AHA statements and you can print out the entire guideline.  This will help you to understand the role of antibiotics and the pros and cons of pretreatment.