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
Cefazolin    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.