Master the board step 3
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Master the board step 3

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Infectious Diseases<br />

Endocarditis Prophylaxis<br />

The only cardiac defects that need prophylaxis are <strong>the</strong> following:<br />

··<br />

Pros<strong>the</strong>tic valves<br />

··<br />

Unrepaired cyanotic heart disease<br />

··<br />

Previous endocarditis<br />

··<br />

Transplant recipients who develop valve disease<br />

The only procedures that need prophylaxis are <strong>the</strong> following:<br />

··<br />

Dental procedures that cause bleeding: The prophylactic antibiotic to use for<br />

dental procedures is amoxicillin. For penicillin-allergic patients, clindamycin<br />

is <strong>the</strong> drug of choice.<br />

··<br />

Respiratory tract surgery<br />

··<br />

Surgery of infected skin<br />

The following procedures do not need prophylaxis:<br />

··<br />

Dental fillings<br />

··<br />

All flexible scopes<br />

··<br />

All OB/GYN procedures<br />

··<br />

All urinary procedures, including cystoscopy<br />

The following cardiac defects do not need prophylaxis:<br />

··<br />

Aortic stenosis or regurgitation<br />

··<br />

Mitral stenosis or regurgitation<br />

··<br />

Atrial or ventricular septal defects<br />

··<br />

Pacemakers and implantable defibrillators<br />

··<br />

Mitral valve prolapse, even if <strong>the</strong>re is a murmur<br />

··<br />

HOCM (IHSS)<br />

What is <strong>the</strong> drug to give as prophylaxis?<br />

··<br />

Dental/oral procedures:<br />

--<br />

Amoxicillin<br />

--<br />

If rash to penicillin: Cephalexin<br />

--<br />

If anaphylaxis to penicillin: Azithromycin, clarithromycin, or clindamycin<br />

··<br />

Skin procedures:<br />

--<br />

Cephalexin<br />

--<br />

If allergic to penicillin: Vancomycin<br />

29

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