Appendix 3

American Heart Association antibiotic

prophylaxis guidelines

Table A4

Prophylactic antibiotic regimens for oral and dental procedures.

Situation

Drug

Oral
Unable to take oral medications

Amoxicillin
Ampicillin
or
cefazolin, or ceftriaxone*
Cephalexin*
or
clindamycin
or
azithromycin or
clarithromycin
cefazolin or ceftriaxone*
or
clindamycin

Allergic to penicillins or
ampicillin-oral

Allergic to penicillins or ampicillin

and unable to take oral medications

Regimen (to be taken 30 min to 60 min before

dental procedure)
adults: 2.0 g/children: 50 mg/kg
adults: 2.0 g IM or IV/ children: 50 mg/kg IM or IV
adults: 1 g IM or IV/ children: 50 mg/kg
adults: 2 g/children: 50 mg/kg
adults: 600 mg/children: 20 mg/kg
adults: 500 mg/children: 15 mg/kg

adults: 1 g IM or IV/children: 50 mg/kg IM or IV.

adults: 600 mg IM or IV/children: 20 mg/kg IM or IV

* Cephalosporins should not be given to an individual with a history of anaphylaxis, angioedema, or urticaria with penicillins or
ampicillin.
Reprinted from Wilson, W., Taubert, K.A., Gewitz, M., et al. (2007) Prevention of infective endocarditis: Guidelines from the
American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular
Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the
Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation, 116:17361754 with permission from
Lippincott, Williams & Wilkins.

The Dentists Drug and Prescription Guide, First Edition. Mea A. Weinberg and Stuart J. Froum.
2013 John Wiley & Sons, Inc. Published 2013 by John Wiley & Sons, Inc.

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220 The dentists drug and prescription guide

Table A5
infection.

Suggested antibiotic prophylaxis regimens in patients at potential increased risk of hematogenous total joint

Situation

Drug

Regimen

Standard general prophylaxis

Cephalexin or
amoxicillin
Cefazolin or
ampicillin
Clindamycin
Clindamycin

2 g orally 1 h before dental procedure

Patients unable to take oral medications

Allergic to penicillin
Allergic to penicillin and unable to take oral medications

1 g IM or IV 1 h before procedure
2 g IM or IV 1 h before procedure
600 mg orally 1 h before procedure
600 mg IV 1 h before procedure

Reprinted from Wilson, W., Taubert, K.A., Gewitz, M., et al. (2007) Prevention of infective endocarditis: Guidelines from the American
Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the
Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and
Outcomes Research Interdisciplinary Working Group. Circulation, 116:17361754 with permission from Lippincott, Williams & Wilkins.

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