Bacterial endocarditis prophylaxis Flashcards
Which patients are at risk for bacterial endocarditis and need prophylaxis?
- prosthetic valves,
- history of endocarditis
- unrepaired cyanotic CHD
- repaired CHD using prosthetic material in the first 6 months after procedure
- repaired CHD with residual defects
- heart transplant with valvular dx
CHD = congenital heart defect
what are some high risk *procedures* that may need bacterial endocarditis prophylaxis?
- dental manipulation of gingival tissue or periapical region of teeth, or perforation of oral mucosa
- respiratory tract procedures with incision or biopsy
-cardiac surgery
- GI/GU tract procedure with ongoing infection
- procedures or surgery with infected skin with musculoskeletal tissue
low risk procedures do NOT need bacterial endocarditis prophylaxis
- GI procedures (ERCP, EGD)
- GU procedures (prostatectomy catheter insertions) as long as no ACTIVE INFECTION
- Vaginal or c section only need prophylaxis if there’s a concurrent infection going on.
What antibiotics do we give for someone who is underlying dental/respiratory procedure and needs endocarditis prophylaxis?
for dental/respiratory procedure
oral: amoxicillin, cephalexin, clindamycin, or azithromycin
IV: ampicillin, ceftriaxone, clindamycin
give 30-60 minutes prior to procedure
What type of antibiotics are given for endocarditis prophylaxis before a GI/GU procedure? (enterococcus)
endocarditis prophylaxis before a GI/GU procedure (b/c of concurrent infection)
amoxicillin, ampicillin, or vancomycin
What type of antibiotics are given for endocarditis prophylaxis before a skin/MSK procedure? (staph and strep coverage)
skin/MSK procedure with concurrent infection prophylaxis
vancomycin, or clindamycin for suspected MRSA
which pts need endocarditis prophylaxis for routine dental procedures such as routine cleaning and tooth extraction:
prior infective endocarditis pts
pts who have a high risk cardiac condition.
in pts who have cirrhosis need bacterial endocarditis prophylaxis when they are:
people variceal bleeding without endoscopy percutaneous gastrostomy tube placement
when they have biliary obstruction or cholangitis and pancreatic cyst
