Antibiotic regimens for prevention of endocarditis prior to dental procedures*

Situation	Agent	Adults	Children
Oral	Amoxicillin	2 g	50 mg/kg
Unable to take oral medication	Ampicillin	2 g IM or IV	50 mg/kg IM or IV
	or
	Cefazolin or ceftriaxone	1 g IM or IV	50 mg/kg IM or IV
Allergic to penicillin or ampicillin—oral	Cephalexin^¶^Δ	2 g	50 mg/kg
	or
	Azithromycin or clarithromycin	500 mg	15 mg/kg
	or
	Doxycycline	100 mg	<45 kg, 2.2 mg/kg >45 kg, 100 mg
Allergic to penicillin or ampicillin and unable to take oral medication	Cefazolin or ceftriaxone^Δ	1 g IM or IV	50 mg/kg IM or IV

Clindamycin is no longer recommended for antibiotic prophylaxis prior to dental procedures.

IM: intramuscular; IV: intravenous.

* Antibiotics should be administered 30 to 60 minutes prior to the procedure.

¶ Or other first- or second-generation oral cephalosporin in equivalent adult or pediatric dosing.

Δ Cephalosporins should not be used for patients with history of anaphylaxis, angioedema, or urticaria with penicillin or ampicillin. In such cases, vancomycin may be used (adults: 15 to 20 mg/kg IV, not to exceed 2 g per dose; children: 15 mg/kg IV to a maximum dose of 1 g).

Graphic 57182 Version 34.0

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Antibiotic regimens for prevention of endocarditis prior to dental procedures*