Recommendations Comments I Procedures in the oral cavity for which prophylaxis is indicated 1. All dental/oral hygiene procedures that involve manipulation of the gums 2. All root canal treatments in which instruments pass through the apical foramen 3. All extractions or removal of root remnants 4. All surgical procedures in the mouth a. Jaw surgical procedures, including incision of an abscess b. Periodontal surgery c. Surgical procedures for implants, including bone anchors used in orthodontic treatment Endocarditis prophylaxis is NOT indicated for: 1. Administration of local anaesthesia 2. Taking intra-oral X-rays (dental films, occlusal views) 3. Placement, adjustment or removal of orthodontic appliances (removable and fixed appliances) 4. Natural loss of (deciduous) teeth 5. Bleeding of the lips or oral mucosa due to trauma II Procedures in the upper airways for which prophylaxis is indicated 1. Tonsillectomy and adenoidectomy 2. Sinus drainage Endocarditis prophylaxis is NOT indicated for procedures such as: 1. Intubation 2. Bronchoscopy with or without biopsy 3. Pleural puncture (thoracentesis) Medication for I and II: Adults: amoxicillin 3 grams orally, preferably as a dispersible formulation, 30-60 minutes before the procedure. Children: amoxicillin suspension 50 mg/kg orally, maximum 3 g, 30-60 minutes before the procedure. Adults: amoxicillin 2 g IV, 30-60 minutes before the procedure. Children: amoxicillin 50 mg/kg IV, maximum 2 g, 30-60 minutes before the procedure. In case of penicillin hypersensitivity or treatment with penicillin within 7 days prior to the procedure: Adults: clindamycin 600 mg orally, 30-60 minutes before the procedure, or: clindamycin 600 mg IV, 30-60 minutes before the procedure. Children: clindamycin orally, 30-60 minutes before the procedure: <10 kg: 150 mg. 10 to 30 kg: 300 mg. 30 to 70 kg: 450 mg 70 kg: 600 mg or: clindamycin 20 mg/kg IV, maximum 600 mg, 30-60 minutes before the procedure.
I Procedures in the oral cavity for which prophylaxis is indicated
1. All dental/oral hygiene procedures that involve manipulation of the gums
2. All root canal treatments in which instruments pass through the apical foramen
3. All extractions or removal of root remnants
4. All surgical procedures in the mouth
a. Jaw surgical procedures, including incision of an abscess
b. Periodontal surgery
c. Surgical procedures for implants, including bone anchors used in orthodontic treatment
Endocarditis prophylaxis is NOT indicated for:
1. Administration of local anaesthesia
2. Taking intra-oral X-rays (dental films, occlusal views)
3. Placement, adjustment or removal of orthodontic appliances (removable and fixed appliances)
4. Natural loss of (deciduous) teeth
5. Bleeding of the lips or oral mucosa due to trauma
II Procedures in the upper airways for which prophylaxis is indicated
1. Tonsillectomy and adenoidectomy
2. Sinus drainage
Endocarditis prophylaxis is NOT indicated for procedures such as:
1. Intubation
2. Bronchoscopy with or without biopsy
3. Pleural puncture (thoracentesis)
Medication for I and II:
amoxicillin 3 grams orally, preferably as a dispersible formulation, 30-60 minutes before the procedure.
amoxicillin suspension 50 mg/kg orally, maximum 3 g, 30-60 minutes before the procedure.
amoxicillin 2 g IV, 30-60 minutes before the procedure.
amoxicillin 50 mg/kg IV, maximum 2 g, 30-60 minutes before the procedure.
In case of penicillin hypersensitivity or treatment with penicillin within 7 days prior to the procedure:
clindamycin 600 mg orally, 30-60 minutes before the procedure,
or:
clindamycin 600 mg IV, 30-60 minutes before the procedure.
clindamycin orally, 30-60 minutes before the procedure:
clindamycin 20 mg/kg IV, maximum 600 mg,
30-60 minutes before the procedure.