Types of Prophylaxis in Medicine

Prophylaxis means preventative, or to prevent. Prophylactic is an adverb and is used to describe, for example: the physician provides prophylactic health care. These words are Greek in origin, from the word "phylax", meaning "to guard" and "watching."

Prophylactic Healthcare

In medicine, the term prophylactic is used to describe surgeries, dental cleanings, vaccines, birth control and many other types of procedures and treatments that prevent something from happening.

A prophylactic hepatitis vaccine prevents the patient from getting hepatitis, while a prophylactic dental cleaning prevents tooth decay.

Types of Prophylactic Care

Preventative care takes many forms and continues even after a disease process has been identified. Generally speaking, prophylaxis doesn't just mean preventing disease, it can also mean preventing a worsening of disease, minimizing the severity of disease and preventing over-treatment.

Primary Prophylaxis: Preventing or increasing resistance to disease that has not occurred. This may include routine medical checkups and vaccinations.

Secondary Prophylaxis: Early detection and treatment of a disease process. This would include screenings for common conditions so they may be treated in their early stages, such as a yearly blood pressure and blood glucose check.

Tertiary Prophylaxis: Treatment to decrease the effects or spread of a disease.

This would include surgery to treat a condition and medications.

Quaternary Prophylaxis: This is the idea that excessive medical treatment should be prevented, and that patients who will not benefit from further medical treatment should not be subjected to it.

Prophylactic In Common Use

In general conversation, the term prophylactic is often a synonym for condom as condoms are considered prophylaxis for unwanted pregnancy.

Prophylactic Antibiotics

The term "prophylactic antibiotics" refers to antibiotics that are given to prevent infection rather than treat infection. Prophylactic antibiotics are avoided whenever possible in healthcare, as the overuse of antibiotics has led to antibiotic resistance, and provides no benefit to the patient. There may be individual instances where the use of antibiotics prior to surgery is deemed to be appropriate, or when a patient is sick enough to warrant the use of antibiotics before blood cultures or other lab results confirm the presence of infection. In these cases, the potential benefit outweighs the risk of harm, and the physician chooses to utilize antibiotics.

That said, there are a few limited times when preventative antibiotics are known to be useful to the vast majority of patients and research supports the use of these medications to prevent harm. All of these instances are for dental procedures, which carry a specific risk of spreading infection to the heart, in particular the hearts of individuals that have (or had) serious heart problems.

Prior to a dental procedure, individuals who have a history of infective endocarditis, a serious heart infection, should have antibiotics.

The same is true of individuals who have had a cardiac transplant with valve problems, people who have had their heart valve replaced and specific types of heart defects that are present at birth.

There is no longer a recommendation that individuals with joint replacements receive antibiotic prophylaxis prior to dental procedures.