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Table of Contents
PREVENTION OF BACTERIAL ENDOCARDITIS
ENDOCARDITIS PROPHYLAXIS FOR DENTAL AND UPPER RESPIRATORY TRACT
Endocarditis Prophylaxis
| Situation |
Agent |
Regimen1 |
| Standard general prophylaxis |
Amoxicillin |
Adults - 2g po
Children - 50mg/kg po 1 hour before procedure |
| Unable to take oral medications |
Ampicillin |
Adults - 2g IM/IV
Children - 50mg/kg IM/IV 30 minutes before procedure |
| Allergic to penicillin |
Clindamycin
or |
Adults - 600mg po
Children - 20mg/kg po1 hour before procedure |
Cephalexin2
or |
Adults - 2g po
Children - 50mg/kg 1 hour before procedure |
Azithromycin
or |
Adults - 500mg po 1 hour before procedure |
| Clarithromycin |
Children - 15mg/kg po 1 hour before procedure |
Allergic to penicillin and
unable to take oral medications |
Clindamycin
or |
Adults
- 600mg IV
Children - 20mg/kg IV 30 minutes before procedure |
| Cefazolin2
|
Adults - 1g IM/IV
Children - 25mg/kg IM/IV 30 minutes before procedure |
1 Total children’s dose should not exceed adult dose.
2
Cephalosporins should not be used in individuals with immediate-type
hypersensitivity reaction (angioedema or anaphylaxis) to penicillins
Reference:
JAMA 1997;277:1794-1801.
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