Prevention of Bacterial Endocarditis

Standard general prophylaxis for patients at risk:

Amoxicillin

2.0g given orally one hour before procedure

Unable to take oral medication:

Amoxicillin

2.0g given IM or IV within 30 minutes before procedure

Amoxicillin/Ampicillin/penicillin-allergic patient:

Clindamycin	600mg given orally one hour before procedure
Cephalexin or Cefadroxil	2.0g orally one hour before procedure
Azithromycin or Clarithromycin	500mg orally one hour before procedure

Amoxicillin/Ampicillin/penicillin-allergic patients unable to take oral medications:

Clindamycin	600mg IV within 30 minutes before procedure
Cefazolin	1.0g IM or IV within 30 minutes before procedure

High-risk patients:

Ampicillin	Ampicillin 2.0g plus Gentamicin 1.5mg/kg
Gentamicin	Not to exceed 120mg IM or IV. Complete injection/infusion within 30 minutes before starting procedure

Moderate-risk patients:

Amoxicillin	2.0g orally one hour before procedure
Ampicillin	2.0g IM or IV within 30 minutes before starting procedure

Moderate-risk patients allergic to Ampicillin/Amoxicillin:

Vancomycin

1.0g over 1-2 hours. Complete infusion within 30 minutes of starting the procedure

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