Queenie's 微笑的黃金

Those in which endocarditis prophylaxis recommended:

High-risk category

• Prosthetic cardiac valves, including bioprosthetic and homograft valves
• Previous bacterial endocarditis
• Complex cyanotic congenital heart disease (e.g., single ventricle states, transposition of the great arteries, tetralogy of Fallot)
• Surgically constructed systemic pulmonary shunts or conduits

Moderate-risk category

• Most other congenital cardiac malformations (other than above and below)
• Acquired valvular dysfunction (e.g., rheumatic heart disease)
• Hypertrophic cardiomyopathy
• Mitral valve prolapse with valvular regurgitation and/or thickened leaflets

Those in which endocarditis prophylaxis not recommended routinely:

Negligible-risk category (no greater risk than the general population)

• Isolated secundum atrial septal defect
• Surgical repair of atrial septal defect, ventricular septal defect, or patent ductus arteriosus (without residua beyond 6 months)
• Previous coronary artery bypass graft surgery
• Mitral valve prolapse without valvular regurgitation
• Physiologic, functional, or innocent heart murmurs
• Previous Kawasaki disease without valvular dysfunction
• Previous rheumatic fever without valvular dysfunction                                                                                                                                                                            Standard general prophylaxis
  Amoxicillin. Adults: 2.0 g; children: 50 mg/kg orally 1 hr before procedure.

  Unable to take oral medications
  Ampicillin. Adults: 2.0 g IM or IV; children: 50 mg/kg IM or IV within 30 mins before procedure.

  Allergic to penicillin
  Clindamycin. Adults: 600 mg; children: 20 mg/kg orally 1 hr before procedure. Cephalexin or cefadroxil. Adults: 2.0 g; children; 50 mg/kg orally 1 hr before procedure. Azithromycin or clarithromycin. Adults: 500 mg; children: 15 mg/kg orally 1 hr before procedure.

  Allergic to penicillin and unable to take oral medications Clindamycin or Cefazolin. Adults: 600 mg; children: 20 mg/kg IV within 30 mins before procedure Adults: 1.0 g; children: 25 mg/kg IM or IV within 30 mins before procedure.

  IM indicates intramuscularly, and IV, intravenously.

  • Total children's dose should not exceed adult dose.
  • Cephalosporins should not be used in individuals with immediate-type hypersensitivity reaction (urticaria, angioedema, or anaphylaxis) to penicillins.
• Cardiac pacemakers (intravascular and epicardial) and implanted defibrillators