Antibiotic Prophylaxis

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Sometimes various medical conditions require that the patient take antibiotics before dental treatment. Taking antibiotics " before-hand" is called " antibiotic prophylaxis". See the chart below to see those medical condition that do/do not required premedications.
PROPHYLAXIS RECOMMENDED PROPHYLAXIS NOT RECOMMENDED
Previous infective endocarditis Isolated secundum atrial septal defect
Cardiac valve prosthesis Coronary bypass surgery
Rheumatic heart disease Previous rheumatic fever without rheumatic heart disease
Hypertrophic cardiomyopathy Congenital pulmonary stenosis
Cardiac transplant with valve dysfunction Cardiac transplant without valve dysfunction
Mitral valve prolapse with valve dysfunction (a) Mitral valve prolapse without valve dysfunction
AV shunt for hydrocephalus Coronary heart disease
Kawasaki disease with valve dysfunction Kawasaki disease without valve dysfunction
Mitral valve surgery Cardiac pacemakers and Implanted defibrillators
Indwelling catheter ( right heart) Physiological, functional, innocent hear murmers
Idiopathic hypertrophic aortic stenosis Orthopedic pins and screws
Surgical repaired intracardiac lesion with residual hemodynamic abnormalities Othopedic joint (b)
Systemic lupus erythematosus with valve dysfunction (f) HIV/AIDS
Myeloproliferative disorders with valve dysfunction (g) Asplenia
Osteogenesis imperfecta with valve dysfunction (h)  
Congential heat disease: aortic stenosis, bicuspid aortic valve, coarctation of the aorta, complex cyanotic heart disease (d), patent ductus arteriosis, systemic pulmonary artery shunt, ventricular septal defect Six months or longer after surgery without residua for (c), : Atrial septal defect, coronary artery stents, noncoronary artery grafts (e), patent ductus arteriosus, ventricular septal defect
 

(a).antibiotic prophylaxis for regurgitation, myxomatous, degeneration, thickened and/or redundant valves particularly in males over age 46

  1. antibiotic prophylaxis should be considered for such patients with :inflammatory arthropathies ( rheumatoid arthritis, systemic lupus erythematosus), disease-, drug-or radiation-induced immunosuppression, insulin-dependent ( type 1) diabetes, first two years following joint replacement, previous prosthetic joint infection; malnourishment, and hemophilia
  2. Lesions with minimal or no hemodynamic abnormality
  3. Includes single ventricle states, transposition of the great arteries, tetralogy of Fallot
  4. Prophylaxis my be considerated for large vascular grafts
  5. Including possibly other collagen disorders
  6. Including polycythemia vera, essential thrombocytopenia, anogenic myeloid metaplasia
  7. Including Marfan’s Ehler-Danlos syndrome, Hurler’s syndrome or pseudoxanthoma elasyicum

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Standard general prophylaxis

Amoxicillin 500mg 

Take four tablet one hour before dental visit.

Children 50mgs/kg not to exceed adult dose
Standard general prophylaxis for patients allergic to amoxicillin/penicillin use one of the following: 

Clindamycin 150mg 

Take four tablets one hour before dental visit Children 20mg/kg not to exceed the adult dosage  

Azithromycin 250mg

Take two tablets one hour before dental visit Children 15 mg/kg not to exceed the adult dosage

Clarithromycin 250 mg

Take two tablets one hour before dental visit Children 15mg/kg not to exceed the adult dosage

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©1998, Jeffrey Kohlhardt DDS, 1204 Cottonwood Street, Suite 4
Woodland, California 95695, (530) 662-7128 dr-k@dentalresource.com