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Dental treatment under general anaesthesia, intravenous sedation, or patients unable to take oral medications |
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Special concern: For those at highest risk of IE eg: Prosthetic Heart Valve or Previous Infective Endocarditis see Table
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The need for a General Anaesthesia (GA) or Intravenous Sedation (IVS) requires a modification to the drug regimen particularly with regard to dosage. |
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Clinical Situation |
Drug |
Regime |
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Patients not allergic to Penicillin or Patients who have not received more than a single dose or course of penicillin in the previous month |
Amoxicillin or Ampicillin |
Adults IV Amoxicillin 2g upon attainment of GA and immediately prior to dental procedure
Children <5 years: IV Amoxicillin 500mg administered upon attainment of GA and immediately prior to dental procedure
5-10 years: IV Amoxicillin 500mg administered upon attainment of GA and immediately prior to dental procedure
>10 years: use adult dose |
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Patients allergic to Penicillin or who have had more than a single dose or course of Penicillin (or other Beta Lactam antibiotic) within the last month |
Clindamycin |
Adults IV Clindamycin 300mg infused over at least 10 minutes upon attainment of GA and immediately prior to dental procedure. This is followed by oral or IV Clindamycin 150mg 6 hours later
Children <5 years: IV Clindamycin 75mg infused over at least 10 minutes upon attainment of GA and immediately prior to dental procedure.
5-10 years: IV Clindamycin 150mg infused over at least 10 minutes upon attainment of GA and immediately prior to dental procedure.
>10 years: use adult dose |