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The American Heart Association has recently changed their recommendations for infective endocarditis prophylaxis in association
with dental/endodontic procedures. It is no longer recommended that patients with Mitral Valve Prolapse, Previous Rheumatic
Fever, Isolated Atrial Septal Defect as well as several other previously recommended conditions premedicate with antibiotics prior
to endodontic procedures, including surgical procedures.
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Cardiac conditions still requiring antibiotic prophylaxis include:
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Prosthetic Heart Valve.
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Previous case of Infective Endocarditis.
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These Congenital Heart Disease (CHD) Conditions:
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Completely repaired CHD with prosthetic material during the first 6 months following the procedure.
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Repaired CHD with residual defect after prosthetic patch.
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Cardiac transplant patients that developed cardiac valvulopathy.
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Please follow the advice of your physician regarding these recent changes. It is to your benefit not to pre-medicate for
dental procedures if no longer necessary.
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In light of current American Heart Association Recommendations, if your physician still recommends that you require
antibiotic prophylaxis prior to dental/endodontic procedures, the following regimens are recommended:
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Amoxicillin 4 - 500 mg. tablets an hour prior to appointments (2000 mg).
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Clindamycin (for those who are allergic to penicillin): 2 - 300 mg. capsules one hour prior to appointments (600 mg).
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In special cases first or second generation cephalosporins may be used.
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