Prophylaxis: Definition, Types, and More

The term prophylaxis means preventive. It comes from the Greek word “phylax,” meaning “to guard” and “watching.” Prophylactic treatment is used in healthcare to preserve health and prevent the spread of disease.

People often associate the word prophylactics with condoms. Condoms are prophylactics that protect the user against sexually transmitted infections (STIs) and prevent pregnancy.

Prophylactic medicine includes vaccines and medications that prevent an illness or a recurrence of a condition (migraines, seizures, etc.). Sometimes prophylaxis involves surgery. For example, a woman at high risk of breast cancer may elect to have a mastectomy.

This article discusses prophylaxis in healthcare. It includes examples of prophylactic medicine and defines levels of prophylactic care.

What Is Prophylactic Health Care?

In medicine, the term prophylactic is used to describe procedures and treatments that prevent something from happening. This can include dental cleanings, vaccines, birth control, and sometimes surgery.

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

Prophylaxis is a good thing in healthcare. It prevents a problem by addressing the potential issue before it actually becomes problematic. The prevention of disease is often easier, faster, less expensive, and less painful than treating the disease.

Types of Prophylactic Care

Preventive care takes many forms. It may even continue after a disease has been identified.

Generally speaking, prophylaxis doesn’t just mean preventing disease. It can also mean preventing the disease from getting worse or preventing over-treatment.

The different types of prophylaxis include primary, secondary, tertiary, and quaternary.

Primary Prophylaxis

At this stage, you want to prevent illness and increase resistance to viruses and diseases that you don’t have. Reducing risk factors through a healthy lifestyle (such as a healthy diet, exercise, and not smoking) is an important part of primary prevention.

This also includes vaccinations and routine health screenings for children and adults. There are vaccines for more than 30 preventable diseases approved for use in the United States, 18 of which are covered by vaccines recommended for routine use. Some vaccines are used only in special situations, such as a disease outbreak or travel to areas where a preventable disease is common.

Having a healthcare professional regularly check your weight, blood pressure, blood sugar, and cholesterol is a good way to stay on top of your health.

Secondary Prophylaxis

If there is an underlying disease process lurking in your body, the goal is to catch it in its earliest stages, especially when you are not feeling ill or having any symptoms. Early diagnosis means it is manageable, treatable, and possibly even curable. Measures should be taken to prevent a minor issue from becoming a major medical problem.

This could mean losing 5% to 7% of weight to reverse pre-diabetes and prevent it from becoming type 2 diabetes or taking a statin to reduce cholesterol in order to prevent a heart attack.

Routine Pap smears, colonoscopies, and mammograms are recommended to make sure there are no signs of cancer. Even removing a polyp from your colon during a colonoscopy helps prevent it from progressing to cancer.

Tertiary Prophylaxis

Once you are having symptoms and diagnosed with a disease, illness, or injury, steps can be taken to minimize symptoms, prevent or slow disease progression, and recover as much function as possible.

Examples include chemotherapy for cancer, rehabilitation programs after stroke, or disease management for heart failure.

Quaternary Prophylaxis

This is the idea that excessive medical treatment can sometimes cause harm and should be prevented. If patients will not benefit from further medical treatment, then they should not be subjected to it.

For example, if a patient does not respond to the first round of chemotherapy, there is no reason to do a second round. Chemotherapy causes side effects, so you can prevent harm by stopping treatment.

Prophylactic Antibiotics

The term prophylactic antibiotics refers to antibiotics that are given to prevent infection rather than treat it.

Prophylactic antibiotics are avoided whenever possible in healthcare. The overuse of antibiotics has led to antibiotic resistance and provides no benefit to the patient.

Your physician may choose to prescribe prophylactic antibiotics because the potential benefit outweighs the risk of harm. In some cases, preventive antibiotics can reduce the risk of infection for patients at high risk. 

Use in Surgery

Some surgeries are at higher risk for bacterial infections so you may be prescribed a preventive antibiotic. These surgeries include:

• Organ transplants
• Cardiac surgery
• Gastrointestinal surgery
• Surgeries for inserting a cardiac device, such as a pacemaker
• Neurosurgery (brain, spine, and nervous system)
• Cesarean section
• Hysterectomy

When undergoing surgery, patients may receive prophylactic antibiotics within 1-2 hours of the skin incision. The antibiotic should be discontinued after 24 hours of surgery completion, or 48 hours if it is cardiothoracic surgery.

Use in Dental Procedures

People with serious heart problems are given prophylactic antibiotics in dental procedures. That’s because dental procedures carry a specific risk of spreading an infection to the heart. High-risk individuals include those with:

• A history of infective endocarditis, a serious heart infection 
• A cardiac transplant with valve problems
• A heart valve replacement
• Specific types of heart defects present at birth
• Some patients receiving chemotherapy who have a central venous catheter

People with joint replacements are no longer recommended to receive antibiotic prophylaxis prior to dental procedures.

Your surgeon will let you know if you should have prophylactic antibiotics before your procedure. They will usually ask questions about your health history to help determine if you are at high risk for infection.

Summary

Prophylactic healthcare helps prevent or reduce the risk of health problems. This preventive care includes dental cleanings, birth control, vaccinations, and regular health screenings, but it can also mean stopping treatment to prevent harm. Prophylactic antibiotics may be given to patients at high risk for infection when undergoing surgery or dental procedures.

A Word From Verywell

Prophylactic, or preventive, healthcare has an important role in helping you stay healthy. Be sure to schedule regular check-ups with your doctor and dentist. They can both work with you to decide what types of prophylactic care are necessary at each stage in life.