PROPHYLAXIS of BACTERIAL ENDOCARDITIS 1


PROPHYLAXIS of BACTERIAL ENDOCARDITIS


If you have congenital heart disease, print out this information and give it to your physician. You can also download a PDF version of the wallet card from AHA.

Antibiotic therapy must be practiced for prophylaxis of the bacterial endocarditis, every tyme the patient must be take surgical manipulations as of diagnostic or therapeutic type, as is indicated in the attached outline.

RATIONAL

In transitory course of batteremia secondary to::

Dental procedures

  1. Dental extractions
  2. Periodontal procedures including surgery, scaling, and root planing, probing, and recall maintenance
  3. Endodontic (root canal) instrumentation or surgery only beyond the apex
  4. Subgingival placement of antibiotic fibers or strips
  5. Initial placement of orthodontic bands but not brackets
  6. Intraligamentary local anesthetic injections
  7. Prophylactic cleaning of teeth or implants where bleeding is anticipated

Respiratory tract

  1. Tonsillectomy and/or adenoidectomy
  2. Surgical operations or biopsy that involve respiratory mucosa
  3. Bronchoscopy with a rigid bronchoscope
  4. woven recording and water-drainage of infect

Genitourinary procedures

Gastronitestinal procedures

The bacteria transport from the blood can localize themselves on the valves or woven it damages to you near anatomical defects with outcome in bacterial endocarditis. That verification in the 30-50% of the children under the two years and in the 70-80% of the children from the 2 to the 15 years with congenital cardiopathy with risk differentiated in:

High Risk CHD for Bacterial Endocarditis

  1. Patent ducstus arteriosus
  2. Interventricular septal defects
  3. Stenosia or aortic coartaction
  4. Systemic-Pulmonaris anastomosis

Medium risk CHD for bacyerial Endocarditis

  1. Pulmonary and tricuspidalis Valvulopaties

Low risk CHD for Bacterial Endocarditis

  1. Interatrial septal defects
  2. Surgical corrected cardiac lesions.

Condition that they do not demand you outlined:

  1. Atrial septal defects operate without patch (after six months)
  2. Patent ductus after six months of closure.

ANTIBIOTICS REGIMEN

DENTAL PROCEDURES WITH BLEEDING Of the GUMS (to extract a single tooth for sitting and to repeat you outlined it in case of multiple extractions)

ORAL SURGICAL PROCEDURES And Of The HIGH RESPIRATORY WAYS

STANDARD THERAPY :

  1. Penicillin V 1 g for os one hour before the prodedura and 500 mg six hours after the firsth dose begins

ALTERNATIVE:

  1. Penicilina G 50,000 U/Kg. ev or im 30/60 min. before and 25,000 U/Kg. six hours after the first dose. In high risk is wanted to be obtained one the maximum protection can be associated
  2. Ampicillina 50 mg/kg/dose i.m. or i.v. and Gentamicina 2 mg/kg/dose.
    For the allergic patients to penicillin can use

  3. Eritromicina 20 mg/kg for the first dose and 10 mg/kg for the second dose or
    Vancomicina e.v. 20 mg/kg/dose.

GASTROINTESTINAL OR GENITO-URINARY TRACTS PROCEDURES:

STANDARD TERAPY :
  1. Ampicillina 50 mg/kg/dose i.m. o i.v. piu’ Gentamicina 2 mg/kg/dose
    30 min. before and 8 hours after

ALTERNATIVE TERAPY :

  1. Amoxicillina 50 mg/kg/dose and
  2. for penicilline allergic patients Vancomicina plus gentamicina



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