The term prophylaxis refers to measures taken in order to prevent disease or health problems, rather than to treat or cure an existing condition. Such measures, sometimes known as preventative care, may also be used to stem an outbreak or minimize the symptoms of someone who has been exposed to an infectious agent or health hazard. This medical term comes from a Greek word meaning "to guard against," a reference to the fact that it is intended to provide protection for patients at risk of disease.
Types of Prophylaxis
There are two main types of prophylaxis: primary and secondary. Any measure taken to prevent an illness before it occurs is primary prophylaxis. This could include getting a vaccination to prevent an illness or brushing teeth to prevent gum disease. Secondary prophylaxis are procedures that help prevent infection after exposure to a disease, or to ease symptoms associated with an illness or health condition. For example, if health care workers are exposed to the Human Immunodeficiency Virus (HIV), they may take antiretroviral drugs to help prevent the virus from developing into an active infection.
Examples of Primary Prophylaxis
Health care providers often recommend primary prophylaxis that can include specific procedures, lifestyle changes, and medications. Dentists use treatments like cleaning and scaling to maintain healthy teeth and gums so patients will be less likely to develop periodontal disease. Lifestyle changes like diet and exercise can also help people stay healthier longer.
Additionally, physical examinations and screening tests are a form of preventative care. Women may receive mammograms as they age to identify early signs of breast cancer, just as men get examinations for prostate enlargement. These prophylactic measures can help medical professionals identify early warning signs and risk factors for disease so patients can get prompt treatment.
Condoms are sometimes referred to as prophylactics because they are designed to reduce the spread of sexually transmitted diseases (STDs) and can also prevent pregnancy. Patients who use prophylactic measures like condoms to prevent contracting a disease can reduce the need for costly and invasive treatments later; some STDs, for example, resist treatment and may become lifelong infections that need to be managed.
On a larger scale, emergency preparedness is another form of preventative care. Since outbreaks can occur in disastrous situations, being prepared for such an event lessens the need for eventual treatment. Public health officials stockpile supplies so they can respond quickly to emerging epidemics and disruptions of social services to minimize the risk of disease; many governments maintain supplies of antibiotics to treat people exposed to anthrax in biological attacks, for example.
Examples of Secondary Prophylaxis
Secondary measures are commonly recommended for handling patients exposed to disease or at risk of infection, for their protection as well as others. Care providers weigh the benefits of offering treatment to prevent the onset of disease against the risk of the treatment. For example, a patient who has had surgery to remove a tumor may receive radiation therapy to prevent the recurrence of cancer. Although the radiation treatment can be hard on the patient, it means he or she is less likely to get cancer again.
For disease management, prophylactic treatments may keep patients more comfortable or reduce the risk of complications. Pregnant women may receive anti-emetic medications to prevent vomiting if they experience severe morning sickness, for instance. Without treatment, the patient might experience dehydration or other complications that could make it hard to continue the pregnancy.
Who Needs Prophylaxis?
Many patients can benefit from routine primary prophylaxis to prevent common illnesses. Groups like the World Health Organization and American Academy of Pediatrics have developed recommendations for patients in various communities, age groups, and regions to help care providers determine when people need examinations, vaccinations, and other preventative care. These formal recommendations are periodically updated to reflect emerging information from the medical community, such as evidence that the risks of a test outweigh the benefits, or that a new procedure might be safer and more effective for disease prevention.
In other situations, a doctor could identify specific risk factors that might be a cause for concern, in which case, a patient could need additional care. When patients meet with their primary care providers, they can discuss their medical histories to determine which measures they should take to protect their health. Risk factors can change over time, and patients should make sure their medical records are kept accurate so their clinicians can spot potential issues as early as possible.
A common example of preventative treatment linked to a risk factor is the anticoagulant medication, sometimes called blood thinners, given to patients with cardiovascular disease to reduce the risk of stroke and heart attacks. Such patients may also need prophylactic antibiotics before surgery or dental procedures to prevent endocarditis, a potentially serious inflammation of the heart. Preexisting conditions like diabetes, liver disease, or respiratory disease may also be considerations when preparing patients for surgery and other procedures that might worsen their conditions. Prophylactic medications could minimize the risk of complications and keep the patient more comfortable.
What Should I Do If My Doctor Recommends Prophylaxis?
For more information about a recommended course of treatment, patients can talk to their health providers. They can ask why a prophylactic procedure is being recommended, if there are alternatives, and what risks may be associated with declining treatment. The clinician should be able to provide information to help the patient make a decision about whether to accept the treatment. If the patient still isn't sure, he or she should seek out a second opinion.
Patients should also ask about potential risks and side effects so they can be prepared. For example, people taking blood thinners tend to bleed and bruise easily, which can be a problem in surgery or for people who are involved in sports. It is also important to get clear, precise directions that include a demonstration of dosing and how to administer medication, use medical devices, or follow recommended prophylactic procedures.
