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Infective Endocarditis (IE) Prophylaxis



Indications (AHA 2007)


  • Prosthetic valve

  • Previous IE

  • Congenital heart disease, specifically: 

    • Unrepaired cyanotic heart disease, including palliative shunts & conduits

    • Congenital heart disease repaired within the last 6 months

    • Repaired but residual defects next to prosthetic material

  • Heart transplant recipients with valvulopathy



Eligible Operative Procedures


  • Dental procedures with mucosal penetration

  • Procedures involving respiratory tract incision (including bronchial biopsy)

  • Procedures involving infected skin/musculoskeletal tissue 



Antibiotic regimens


  • One dose 30-60 min prior to the procedure

  • Recommended agent is amoxicillin

    • 2g PO for adults

    • 50mg/kg PO for children 

  • ​Keflex 

    • 2g PO for adults

    • 50mg/kg PO for children

  • Ampicillin 

    • 2g IV for adults

    • 50mg/kg IV for children

  • Cefazolin or ceftriaxone

    • 1g IV for adults

    • 50mg/kg IV for children

  • Clindamycin 

    • 600mg IV for adults

    • 20mg/kg IV for children

  • Azithromycin or clarithromycin

    • 500mg PO for adults

    • 15mg/kg PO for children 


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