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Antibiotic Prophylaxis for Infective Endocarditis (IE) Guidelines 

Adapted from ACC/AHA guidelines 2007: 




  • Prosthetic heart valves, including bioprosthetic and homograft valves

  • A previous history of IE

  • Unrepaired cyanotic congenital heart disease, including palliative shunts and conduits

  • Completely repaired congenital heart defects with prosthetic material or device during the first six months after the procedure (whether placed by surgery or by catheter intervention)

  • Repaired congenital heart disease with residual defects at the site or adjacent to the site of the prosthetic patch or prosthetic device

  • Valve regurgitation due to a structurally abnormal valve in a transplanted heart



Eligible Procedures 


  • Dental procedures with mucosal penetration

  • Procedures involving respiratory tract incision (including bronchial biopsy)

  • Procedures involving infected skin/musculoskeletal tissue 



Perioperative IV Antibiotic Regimens


  • No penicillin allergy: Ampicillin 2g OR Cefazolin/Ceftriaxone 1g 

  • If penicillin allergy: 

    • Cefazolin/Ceftriaxone 1g (DO NOT USE IF SEVERE PENICILLIN ALLERGY) 

    • Clindamycin: 600mg 

    • Vancomycin: 15 to 20 mg/kg, with max 2 g per dose





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