Page 196 - HPP ANTIMICROBIAL GUIDELINE 2018

CHEMOPROPHYLAXIS

Infective Endocarditis

IE prophylaxis recommended for patients with the highest risk cardiac conditions undergoing procedures likely to result in bacteraemia with a microorganism
that has the potential ability to cause bacterial endocarditis

For highest risk procedures:
• Dental procedures that involve manipulation of either gingival tissue or the periapical region of teeth or perforation of the oral mucosa; this does not include
routine dental cleaning.
• Procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa
• Procedures in patients with ongoing gastrointestinal (GI) or genitourinary (GU) tract infection
• Procedures on infected skin, skin structure, or musculoskeletal tissue
• Surgery to place prosthetic heart valves or prosthetic intravascular or intracardiac materials

Genitourinary or gastrointestinal procedures:
IE prophylaxis only if ongoing GI or GU tract infection. Require activity against enterococci (amoxicillin or ampicillin) or vancomycin for penicillin allergic

Maintenance of optimal oral hygiene may reduce the incidence of bacteraemia from daily activities and is more important than prophylactic antibiotics for a
dental procedure to reduce the risk of IE.

Suggested Treatment
Infection/Condition Comments
Preferred Alternative

Infective Endocarditis (IE) Amoxicillin 50mg/kg PO 0.5-1 hour Ampicillin IV 50mg/kg
before procedure
Include coverage for
staphylococcus for surgical Penicillin Allergy :
procedures on infected skin, Clindamycin 20mg/kg IV/PO 0.5-1 hour
skin structure, or before procedure
musculoskeletal tissue

HPP AMG Chemoprophylaxis 93