What is the recommended endocarditis prophylaxis for a patient diagnosed with mitral valve prolapse (MVP)?

Patients diagnosed with mitral valve prolapse (MVP) typically do not require endocarditis prophylaxis. The current guidelines have shifted to recommend that antibiotic prophylaxis is generally unnecessary for most patients with MVP, especially if there is no evidence of mitral regurgitation or other additional risk factors for infective endocarditis. This aligns with the evolving understanding of endocarditis risk and the limited benefit of prophylaxis in many instances.

Endocarditis prophylaxis is primarily indicated for patients with specific heart conditions that carry a higher risk of developing endocarditis following certain procedures. For instance, individuals with prosthetic heart valves, a history of infective endocarditis, unrepaired congenital heart defects, or heart transplants with valve regurgitation are among those who may require prophylaxis. Therefore, in the absence of these higher-risk factors, patients with MVP alone are not usually prescribed prophylactic antibiotics for dental or urologic procedures.

This approach helps to minimize unnecessary use of antibiotics and the potential for adverse effects, while still ensuring that those who truly need prophylaxis receive it.