The Dentist’s Drug and Prescription Guide, First Edition. Mea A. Weinberg and Stuart J. Froum.

© 2013 John Wiley & Sons, Inc. Published 2013 by John Wiley & Sons, Inc.

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Appendix 3

American Heart Association antibiotic prophylaxis guidelines

Table A4 Prophylactic antibiotic regimens for oral and dental procedures.

Situation Drug

Regimen (to be taken 30 min to 60 min before

dental procedure)

Oral Amoxicillin adults: 2.0 g/children: 50 mg/kg

Unable to take oral medications Ampicillin

or

cefazolin, or ceftriaxone *

adults: 2.0 g IM or IV/ children: 50 mg/kg IM or IV

adults: 1 g IM or IV/ children: 50 mg/kg

Allergic to penicillins or

ampicillin-oral

Cephalexin *

or

clindamycin

or

azithromycin or

clarithromycin

adults: 2 g/children: 50 mg/kg

adults: 600 mg/children: 20 mg/kg

adults: 500 mg/children: 15 mg/kg

Allergic to penicillins or ampicillin

and unable to take oral medications

cefazolin or ceftriaxone *

or

clindamycin

adults: 1 g IM or IV/children: 50 mg/kg IM or IV.

adults: 600 mg IM or IV/children: 20 mg/kg IM or IV

* Cephalosporins should not be given to an individual with a history of anaphylaxis, angioedema, or urticaria with penicillins or ampicillin. Reprinted from Wilson, W., Taubert, K.A., Gewitz, M., et al . (2007) Prevention of infective endocarditis: Guidelines 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 , 116:1736–1754 with permission from Lippincott, Williams & Wilkins.

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220 The dentist’s drug and prescription guide

Table A5 Suggested antibiotic prophylaxis regimens in patients at potential increased risk of hematogenous total joint

infection.

Situation Drug Regimen

Standard general prophylaxis Cephalexin or

amoxicillin

2 g orally 1 h before dental procedure

Patients unable to take oral medications Cefazolin or

ampicillin

1 g IM or IV 1 h before procedure

2 g IM or IV 1 h before procedure

Allergic to penicillin Clindamycin 600 mg orally 1 h before procedure

Allergic to penicillin and unable to take oral medications Clindamycin 600 mg IV 1 h before procedure

Reprinted from Wilson, W., Taubert, K.A., Gewitz, M., et al . (2007) Prevention of infective endocarditis: Guidelines 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 , 116:1736–1754 with permission from Lippincott, Williams & Wilkins.

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