Treatment guidelines for health staff infective endocarditis prophylaxis prior to dental procedures



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TREATMENT GUIDELINES FOR HEALTH STAFF
INFECTIVE ENDOCARDITIS PROPHYLAXIS PRIOR TO DENTAL PROCEDURES

Authorized health and wellness staff may provide antibiotic prophylaxis for the prevention of infective endocarditis in certain dental patients as follows:




  1. Follow the American Heart Association (AHA) and American Dental Association (ADA) Guidelines which recommend that patients take antibiotic prophylaxis if there is a history of total joint replacement within two years, artificial heart valves, a previous history of infective endocarditis, certain congenital heart conditions and certain heart transplant patients. The AHA and ADA do not recommend antibiotic prophylaxis for the following conditions: mitral valve prolapse, certain congenital heart conditions such a ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy.




  1. For those students at high risk of infective endocarditis, the ADA recommends antibiotic prophylaxis before invasive dental procedures such as teeth cleaning and extractions.




  1. Administer amoxicillin 2 grams orally in a single dose 30-60 minutes before the procedure.




  1. Alternative treatment if allergic to penicillin: administer clindamycin 600 mg orally OR azithromycin 500 mg orally OR clarithromycin 500 mg orally in a single dose 30-60 minutes before the procedure.




  1. Instruct the student to return for re-treatment if vomiting occurs before dental treatment is completed.




  1. If the antibiotic dose is inadvertently not administered before the procedure, the dose may be administered up to two hours after the procedure.



WHEN TO REFER TO THE CENTER PHYSICIAN




  • If the student needs endocarditis prophylaxis for respiratory, gastrointestinal or genitourinary tract procedures (i.e., other than dental).





July 2015


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