Canterbury DHB

Context

Bacterial Endocarditis Prophylaxis

The National Heart Foundation (www.heartfoundation.org.nz - see New Zealand Guideline for Prevention of Infective Endocarditis Associated with Dental and Other Medical Interventions) recommends prophylaxis for patients with the following conditions:

who are undergoing tonsillectomy, adenoidectomy or dental procedures involving manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa.

Consult with Infectious Diseases for complex patients such as those who have had recent prolonged exposure to antimicrobials.

In This Section

Dental Procedures, Tonsillectomy, and Adenoidectomy

Surgery and Procedures at Sites of Established Infection

Dental Procedures, Tonsillectomy, and Adenoidectomy

amoxicillin

HMLSchedNZFPMLnoids

PO 2000 mg one hour before the procedure, or

 

IV 2 g just before the procedure, or

 

IM 2 g 30 minutes before the procedure

Penicillin allergy

clindamycin

HMLSchedNZFPMLnoids

PO 600 mg one hour before the procedure, or

 

IV 600 mg over at least 20 minutes just before procedure, or

 

IM 600 mg 30 minutes before the procedure

If the antimicrobial has been missed it can be given up to 2 h post-procedure.

Surgery and Procedures at Sites of Established Infection

Treatment regimens should include the following antimicrobials:

 

First-line

Second-line

Dental or upper respiratory tract

amoxicillin

clindamycin (penicillin allergy)

Gastrointestinal, hepatobiliary, genitourinary, obstetric/gynaecological

amoxicillin

vancomycin (penicillin allergy)

Skin, skin structure, or musculoskeletal infections

flucloxacillin

cefazolin (mild penicillin allergy)

clindamycin (severe penicillin allergy or MRSA)

Information about this Canterbury DHB document (99213):

Document Owner:

Not assigned (see Who's Who)

Last Updated:

March 2018 (Cardiovascular System)

Next Review Due:

March 2021

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.

Topic Code: 99213