8/7/2019 antibioticprophylaxsisquickrefguide

1/2

The following was reviewed by the AAE Clinical Practice Committee. AAE members may copy this quick

reference guide for distribution to patients or referring dentists.

The American Heart Association recently revised its guidelines on antibiotic prophylaxis. The current practiceo giving patients antibiotics prior to a dental procedure is no longer recommended EXCEPT or patients withthe highest risk o adverse outcomes resulting rom bacterial endocarditis. In response, the American Association

o Endodontists has prepared a reerence guide or applying the revisions to dental/endodontic procedures andpatient care.

The new AHA guidelines or antibiotic prophylaxis are based on a comprehensive review o published studies thatsuggests inective endocarditis is more likely to occur as a result o daily activities such as brushing and ossingthan rom a dental procedure. For patients at risk o bacterial endocarditis, the AHA emphasizes the importance o

good oral health and regular dental visits.

The new recommendations apply to many dental procedures, including teeth cleaning and extractions. Patientswith congenital heart disease can have complicated circumstances. I there is any question at all as to the categorythat best fts their needs, these patients should check with their cardiologists beore treatment.

BACTERIAL ENDOCARDITIS

Endocarditis Prophylaxis RecommendedPreventive antibiotics prior to a dental procedure are advised for patients with: Artifcial heart valves

Inective endocarditis history Certain specifc, serious congenital (present rom birth) heart conditions, including:

Unrepaired or incompletely repaired cyanotic congenital heart disease, as well as those with palliative shunts

and conduits Completely repaired congenital heart deect with prosthetic material or device, whether placed by surgery or

by catheter intervention, during the frst six months ater the procedure Any repaired congenital heart deect with residual deect at the site or adjacent to the site o a prosthetic

patch or a prosthetic device Cardiac transplant that develops a problem in a heart valve

Endocarditis Prophylaxis Not RecommendedPatients who have taken prophylactic antibiotics routinely in the past but no longer need them includepeople with: Mitral valve prolapse Rheumatic heart disease

Bicuspid valve disease Calcifed aortic stenosis Congenital heart conditions, such as ventricular septal deect, atrial septal deect and hypertrophic

cardiomyopathy

AAE Quick Reference Guide

ANTIBIOTIC PROPHYLAXIS

2008, American Association o Endodontists, 211 E. Chicago Ave., Suite 1100, Chicago, IL 60611

Phone: 800/872-3636 (North America) or 312/266-7255 (International); Fax: 866/451-9020 (North America) or 312/266-9867 (International)

E-mail: info@aae.org; Web site: www.aae.org

8/7/2019 antibioticprophylaxsisquickrefguide

2/2

Regimens for a Dental Procedure1

Regimen: Single Dose 30 to 60 minBefore Procedure

SITUATION AGENT ADULTS CHILDREN

Oral Amoxicillin 2 g 50 mg/kg

Unable to take oralmedication

AmpicillinOR

Ceazolin or cetriaxone

2 g IM* or IV+

1 g IM or IV

50 mg/kg IM or IV

50 mg/kg IM or IV

Allergic to penicillins or

ampicillinoral

Cephalexin OR

ClindamycinOR

Azithromycin or clarithromycin

2 g

600 mg

500 mg

50 mg/kg

20 mg/kg

15 mg/kg

Allergic to penicillins or

ampicillin and unable to

take oral medication

Ceazolin or cetriaxoneOR

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 Or other frst- or second-generation oral cephalosporin in equivalent adult or pediatric dosage. Cephalosporins should not be used in an individual with a history o anaphylaxis, angioedema, orurticaria with penicillins or ampicillin.

1American Dental Association Division o Legal Aairs. An Updated Legal Perspective o Antibiotic Prophylaxis. The Journal o the

American Dental Association. 2008; 139:10-21S.

Patients With Joint ReplacementThere have been no changes to the American Academy o Orthopaedic Surgeons recommendations. Pleasevisit www.aaos.orgor more inormation.

Copyright 2007 American Dental Association. All rights reserved. Reprinted by permission.