Approach to antibiotic prophylaxis against infective endocarditis for patients undergoing dental procedures

IE: infective endocarditis.

* The following dental procedures and events do not require prophylaxis: anesthetic injections through noninfected tissue, taking dental radiographs, placement or adjustment of removable prosthodontic or orthodontic appliances, placement of orthodontic brackets, shedding of primary teeth, and bleeding from trauma to lips or oral mucosa.

¶ Antibiotics should be administered as a single oral dose 30 to 60 minutes prior to the procedure. If inadvertently not given prior to the procedure, antibiotics may be administered up to 2 hours after the procedure. For guidance on parenteral regimens (eg, for patients unable to take oral/enteral agents), refer to separate UpToDate content.

Δ Refer to UpToDate content on other measures to reduce the risk of IE.

◊ Other first- or second-generation oral cephalosporins are acceptable. Cephalosporins should not be used for patients with history of immediate allergy (eg, anaphylaxis, angioedema, urticaria, hypotension) or any severe reaction to a penicillin antibiotic.