Table 4: Endocarditis Prophylactic Regimens for Dental, Oral, Respiratory Tract, and Esophageal Procedures

Table 4:
Endocarditis Prophylactic Regimens for Dental, Oral, Respiratory Tract, and Esophageal Procedures
Situation	Agent	Regimen¹
Standard general prophylaxis	Amoxicillin	Adults: 2.0 g; children 50 mg/kg, orally 1 h before procedure
Unable to take oral medications	Ampicillin	Adults: 2.0 g IM or IV; children 50 mg/kg IM or IV within 30 min before procedure
Patient is allergic to penicillin	Clindamycin or	Adults: 600 mg; children 20 mg/kg orally 1 h before procedure
	or Cefadroxil² or cephalexin²	Adults: 2 g; children 50 mg/kg orally 1 h before procedure
	or Azithromycin or clarithromycin	Adults: 500 mg; children 15 mg/kg orally 1 h before procedure
Allergic to penicillin and unable to take oral medications	Clindamycin	Adults: 600 mg; children 20 mg/kg IV within 30 minutes before procedure
Allergic to penicillin and unable to take oral medications	or Cefazolin²	Adults: 1.0 g; children 25 mg/kg IM or IV within 30 min before procedure
1. The total pediatric dose should not exceed the adult dose. 2. Cephalosporins should not be used in patients with an immediate-type hypersensitivity reaction (urticaria, angioedema or anaphylaxis) to penicillins. Adapted from Dajani AS, Taubert KA, Wilson W, et al. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. JAMA. 1997; 277:1794-1801. Copyright 1997, American Medical Association.