Dental Antibiotic Prophylaxis

• Antibiotic prophylaxis is reasonable in patients at high risk for IE before dental procedures that involve mucosal bleeding.
• High risk features:
  • prosthetic cardiac valve
  • history of IE
  • unrepaired cyanotic congenital heart disease
  • repaired congenital heart defect with prosthesis or shunt (≤6 months postprocedure) or residual defect
  • valvulopathy following cardiac transplantation
  • prosthetic material used for cardiac valve repair (annuloplasty rings and chords)
• Preferred agent is oral amoxicillin 30 to 60 minutes before the procedure.
  • If the patient is allergic to penicillin, use cephalexin, azithromycin, clarithromycin, or clindamycin.

References:

• MKSAP