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AHA Prophylaxis Guidelines
For Prevention Of Bacterial Endocardiditis

Recommended Prophylactic Regimen For Dental, Oral, Or Upper Respiratory Procedures In Patients Who Are At Risk

Condition

Drug

Adult Dose

Standard regimen

Amoxicillin

2 g po 1 h before procedure

Amoxicillin/penicillin allergic patients

Clindamycin or

Cephalexin or cefadroxil or

Azithromycin or clarithromycin

600 mg po 1 h before procedure

2 g po 1 h before proceedue

500 mg po 1 h before procedure

Patients unable to take oral medication

Ampicillin

2 g IV/IM 30 min before procedure

Patients unable to take oral medications and are ampicillin/amoxicillin/penicillin allergic

Clindamycin or


Cefazolin

600 mg IV 30 min before procedure

1 g 30 min before procedure</td

Regimens For Genitourinary/Gastrointestinal (excluding esophageal) Procedures

Condition

Drug

Adult Dose

Standard regimen

Ampicillin

and

Gentamicin

PLUS

Amoxicillin or Ampicillin

2 g IV/IM 30 min before procedure.


1.5 mg/kg IV/IM (maximum 80 mg) 30 min before procedure.


1 g po 6 h after initial dose or
1 g IV/IM 6 h after initial dose

Ampicillin/Amoxicillin/penicillin allergic patients

Vancomycin

and

Gentamicin

1 g IV over 1-2 h completing within 30 min of starting procedure


1.5 mg/kg IV/IM (maximum 120 mg) completing within 30 min of starting procedure

Alternate regimen for low-risk patients

Amoxicillin or

Ampicillin

2 g po 1 h before procedure

2 g IM/IV within 30 min of starting procedure

 

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