Anesthesia Considerations 

Infective Endocarditis (IE) Prophylaxis

 

 

Indications (AHA 2007)

 

• Prosthetic valve

• Previous IE

• Congenital heart disease, specifically: 

  • Unrepaired cyanotic heart disease, including palliative shunts & conduits

  • Congenital heart disease repaired within the last 6 months

  • Repaired but residual defects next to prosthetic material

• Heart transplant recipients with valvulopathy

 

 

Eligible Operative Procedures

 

• Dental procedures with mucosal penetration

• Procedures involving respiratory tract incision (including bronchial biopsy)

• Procedures involving infected skin/musculoskeletal tissue 

 

 

Antibiotic regimens

 

• One dose 30-60 min prior to the procedure

• Recommended agent is amoxicillin

  • 2g PO for adults

  • 50mg/kg PO for children 

• ​Keflex 

  • 2g PO for adults

  • 50mg/kg PO for children

• Ampicillin 

  • 2g IV for adults

  • 50mg/kg IV for children

• Cefazolin or ceftriaxone

  • 1g IV for adults

  • 50mg/kg IV for children

• Clindamycin 

  • 600mg IV for adults

  • 20mg/kg IV for children

• Azithromycin or clarithromycin

  • 500mg PO for adults

  • 15mg/kg PO for children