Search DocQuery
Indications :
- Current indications for endocarditis prophylaxis include:
- a history of IE
- cardiac transplantation with valve regurgitation due to a structurally abnormal valve;
- a prosthetic valve
- prosthetic material used for cardiac valve repair, including annuloplasty rings and clips
- left ventricular assist device
- unrepaired cyanotic congenital heart disease
- repaired congenital cyanotic heart disease with residual defects at the site or adjacent to the site of a prosthetic patch or device
- a defect that has been repaired (surgical or catheter based) with prosthetic material within the previous 6 months
- surgical or transcatheter pulmonary artery valve or conduit placement, such as Melody valve and Contegra conduit
Treatment:
- Amoxicillin (2 g once orally 60 minutes before the cleaning) is the first line for prophylaxis for dental procedures
- Azithromycin should be reserved for patients able to take oral antibiotics who have a penicillin allergy.
- Intravenous ceftriaxone should be used for endocarditis prophylaxis only in patients unable to take oral antibiotics.
- Clindamycin is associated with more adverse outcomes, including Clostridioides difficile infection, compared with the other options and is no longer recommended for endocarditis prophylaxis.
References: