para>Prosthetic cardiac valve
Previous infectious endocarditis (IE)
Congenital heart disease (CHD)
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Unrepaired cyanotic CHD, including palliative shunts and conduits
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Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure
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Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)
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Cardiac transplantation recipients who develop cardiac valvulopathy
TABLE C-2.Infectious Endocarditis Prevention Antibiotic Regimens for Dental ProceduresView LargeTABLE C-2.Infectious Endocarditis Prevention Antibiotic Regimens for Dental Procedures Situation Agent Regimen: Single Dose 30 to 60 min Before Procedure Adults Children Oral Amoxicillin 2 g 50 mg/kg Unable to take Ampicillin OR 2 g IM or IV 50 mg/kg IM or IV oral meds cefazolin or ceftriaxone 1 g IM or IV 50 mg/kg IM or IV Allergic to Cephalexin a,b OR 2 g 50 mg/kg penicillins or clindamycin OR 600 mg 20 mg/kg ampicillin " oral azithromycin or clarithromycin 500 mg 15 mg/kg Allergic to penicillins or ampicillin and unable to take oral medication Cefazolin or ceftriaxone b OR clindamycin 1 g IM or IV 600 mg IM or IV 50 mg/kg IM or IV 20 mg/kg IM or IV IM, intramuscular; IV, intravenous. aOr other first- or second-generation oral cephalosporin in equivalent adult or pediatric dosage. bCephalosporins should not be used in an individual with a history of anaphylaxis, angioedema, or urticaria with penicillins or ampicillin.Adapted from Dajani AS, Taubert KA, Wilson W, et al. Prevention of bacterial endocarditis. JAMA 1991;227:1794 " 1801, and Baltimore RS, Newburger JW, Strom BL, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;115. http://www.circulationaha.org. Accessed November 5, 2007.
Antibiotic prophylaxis is no longer recommended for any other form of congenital heart disease (CHD), except for the conditions listed in Table C-1. Antibiotic prophylaxis is recommended for procedures on the respiratory tract or infected skin, skin structures, or musculoskeletal tissue only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE (Table C-1). Antibiotic prophylaxis solely to prevent IE is not recommended for GU or GI tract procedures.
TABLE C-3.Dental Procedures for which Endocarditis Prophylaxis Is Not RecommendedView LargeTABLE C-3.Dental Procedures for which Endocarditis Prophylaxis Is Not Recommended
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Routine anesthetic injections through noninfected tissue
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Dental radiographs
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Placement of removable prosthodontic or orthodontic appliances
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Adjustment of orthodontic appliances
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Placement of orthodontic brackets
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Shedding of deciduous teeth
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Bleeding from trauma to the lips or oral mucosa.