Which procedure requires prophylactic antibiotics in a patient with a history of infective endocarditis?

In patients with a history of infective endocarditis, prophylactic antibiotics are primarily recommended for procedures that can result in bacteremia, particularly those involving the respiratory tract or the gastrointestinal, genitourinary, or skin flora. Ureteroscopy for infected urolithiasis falls under this category, as it involves manipulation of the urinary tract where bacteria might enter the bloodstream and pose a risk of infective endocarditis.

The rationale for using prophylactic antibiotics in this scenario is to prevent the introduction of bacteria into the bloodstream during invasive procedures, which could subsequently colonize on damaged heart valves or other cardiac structures in susceptible individuals. This is particularly important for patients with a heightened risk, such as those with a history of infective endocarditis.

In contrast, the other procedures listed do not universally require prophylactic antibiotics for patients with a history of infective endocarditis. Surgery for a deviated septum and excision of a non-infected mole are considered to have a lower risk of causing bacteremia, and thus do not necessitate antibiotic prophylaxis in most cases. Colonoscopy for polyp removal, while involving the gastrointestinal tract, generally does not fall under the specific recommendations for prophylaxis unless there are certain complicating factors, such