Endocarditis prophylaxis - procedures in the urogenital tract

All diagnostic and surgical procedures during which antibiotics are administered to prevent wound infection or sepsis. The antibiotics given should therefore be targeted at enterococci.

For example:

• Cystoscopy in a patient with (suspected) urinary tract infection

Endocarditis prophylaxis is NOT indicated for procedures such as:

1. Insertion or removal of an IUD
2. Uncomplicated delivery
3. Termination of pregnancy by curettage
4. Insertion/removal of a bladder catheter

• Adults:
  
  amoxicillin 3 grams orally, preferably in dispersible form, 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 before the procedure:

• Adults:
  
  vancomycin 1 gram as an infusion over 1 to 2 hours, 1-2 hours before the procedure.
• Children:
  
  vancomycin 10 mg/kg as an infusion over 1 to 2 hours, 1-2 hours before the procedure.