Endocarditis prophylaxis
DefinitionThis section has been translated automatically.
Recommended prophylaxis for patients at risk of endocarditis (according to the current guidelines of the professional societies). The antibiotic prophylaxis has been reduced to the group of patients with the highest probability of a severe or lethal course of infective endocarditis.
IndicationThis section has been translated automatically.
- patients with valve replacement (mechanical or biological prostheses)
- Patients with reconstructed valves with alloprosthetic material in the first 6 months
- Patients with survived endocarditis
- Patients with congenital heart defects:
- cyanotic heart defects without surgical correction or with palliative shunt
- operated heart defects with residual defects (i.e. turbulent blood flow)
- all operated or interventionally treated heart defects within the first 6 months after surgery
- heart transplanted patients who develop cardiac valvulopathy
- Endocarditis prophylaxis in urogenital surgery.
ImplementationThis section has been translated automatically.
Recommended prophylaxis for patients with skin infections and skin surgery: Oral administration should be administered approx. 1 hour before the procedure, for parenteral administration the administration should be stopped 30 minutes before the procedure. If endocarditis prophylaxis has been missed, it is advisable to administer it up to 4 hours after the procedure.
- Dosage for adults:
- Amoxicillin: 3 g p.o. Alternatively: 2.2 g ampicillin/clavulanic acid i.v. Alternatively: for beta-lactam allergy clindamycin 600 mg i.v. or vancomycin 1 g i.v. (infusion over 1 hour).
- For MRSA: Vancomycin 1 g i.v.
- Dosage for children:
- Amoxicillin: 50 mg/kg bw i.v.; at first application 20 mg/kg bw i.v.; at second application: Amoxycillin 30 mg/kg bw i.v. Alternatively for MRSA: Vancomycin 20 mg/kg bw i.v. (maximum 1 g ).
LiteratureThis section has been translated automatically.
- Naber VK et al (2007) Prophylaxis of infective endocarditis. Cardiologist 1: 243-250
- Wilson W et al (2007) Prevention of infective endocarditis: guidelines from the american heart association: a guideline from the american heart association rheumatic fever, endocarditis, and kawasaki disease committee, council on cardiovascular disease in the young, and the council on clinical cardiology, council on cardiovascular surgery and anesthesia, and the quality of care and outcomes research interdisciplinary working group. Circulation 116: 1736-1754