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Prophylaxis for infective endocarditis in dental patients undergoing interventional procedures (adults and children)

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Antibiotic prophylaxis is NOT routinely required for the majority of patients undergoing dental procedures.

Which patients require antibiotic prophylaxis?

Healthcare professionals should regard patients with the following cardiac conditions as being at
increased risk of developing infective endocarditis and prescribe these patients antibiotics:

  • Patients with any prosthetic valve, including a transcatheter valve, or those in whom any
    prosthetic material was used for cardiac valve repair;
  • Patients with a previous episode of infective endocarditis
  • Patients with cyanotic congenital heart disease (CHD) who continue to be cyanosed
  • Any type of CHD repaired with a prosthetic material, whether placed surgically or by
    percutaneous techniques, up to 6 months after the procedure or lifelong if residual shunt or valvular regurgitation remains

In all cases clinicians should discuss the risks associated with/without antimicrobial prophylaxis with the patient and record in clinical records as appropriate. Advice should also be given on symptoms that may indicate infective endocarditis and when to seek expert advice.

Antibiotic Prophylaxis Required

Single dose 60 minutes before the procedure.

Adults Oral Amoxicillin 3g (Single dose Oral Powder Sachet)
In true penicillin or beta lactam allergy
Oral Clindamycin 600mg
Children Oral Amoxicillin 50mg/kg (maximum dose 3g)
In true penicillin or beta lactam allergy
Oral Clindamycin 20mg/kg (maximum dose 600mg)
Editorial Information

Last reviewed: 19 May 2021

Next review: 31 May 2024

Author(s): Ysobel Gourlay

Version: 2

Approved By: Antimicrobial Utilisation Committee