Quality Resource Guide

Contemporary Approaches to Antibiotic Prophylaxis 1st Edition

www.metdental.com

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Table 4

Special Considerations

•

Patients who are at risk for IE can receive any indicated dental care

•

Coronary artery bypass graft (CABG) or coronary artery stents (after endothelialization) do not routinely require antibiotic prophylaxis

prior to dental treatment

•

If unanticipated bleeding occurs in a patient at risk for endocarditis, prophylaxis should be given within 2 hours of the procedure to be

effective

•

If a patient is taking oral penicillin for other purposes, clinicians should consider clindamycin for prophylaxis to cover any penicillin-

resistant streptococci

NOTE:

If a patient is already receiving chronic antibiotic therapy with an antibiotic that is also recommended for IE prophylaxis, it is prudent to select an

antibiotic from a different class rather than to increase the dosage of the current antibiotic or preferably delay dental treatment for 10 days after completion of

the antibiotic therapy to allow time for the usual oral flora to be re-established.