Endocarditis Prophylaxis (Prevention)
Bacterial Endocarditis sometimes called Sub-acute Bacterial Endocarditis (SBE) is an infection that can develop inside the heart. This infection can be prevented. The prevention requires, in most cases, only one or two doses of medicine.
Who Needs Bacterial Endocarditis Prophylaxis?
1. All children and adults who have a congenital heart defect, who have not had surgery to repair the defect. The only exceptions to this are children with Atrial Septal Defects (ASD).
2. Children and adults with heart valve problems or have had valve replacement surgery, pulmonary shunts or conduits.
3. All children and adults who have had heart surgery. For some patients, this prevention only lasts for 6 months following their surgery, if there are no residual problems with their hearts. These patients include those who have had:
- Heart transplantation
- Atrial Septal Defect (ASD)
- Ventricular Septal Defect (VSD)
- Patent Ductus Arteriosus (PDA)
4. All children and adults who have had endocarditis in the past.
5. Children and adults who have hypertrophic cardiomyopathy.
How Can the Infection Get into the Heart?
The bacteria enter the blood stream through an injured blood vessel and travel through the blood system to the heart. Once the bacteria enter the heart, they become trapped and the infection starts.
How Do I Know If My Child or I have Endocarditis?
You will likely see development of a persistent fever and signs of illness such as headache, low energy and joint pain. Your doctor will make the diagnosis of endocarditis.
What Procedures Require SBE Prevention?
1. All dental procedures likely to involve bleeding (extraction, cleaning, drilling). Note: if your child is losing baby teeth or having braces adjusted, no medicine is needed.
2. All surgical procedures involving your child's respiratory (breathing), gastric (stomach), and urinary systems. Note: Medicines are not needed for the following procedures; placement of ear tubes, hernia repair, circumcision, cuts that do not require sutures and tubes placed in the bladder or stomach as long as there is no infection.
Medicine Plan for Endocarditis Prevention
For Dental, Oral, Respiratory Tract, Esophageal Procedures
Medicines by Mouth
The doctor will prescribe one of the following medicines for your child or you to take by mouth.
The dose should be given one hour before the procedure (i.e. dental appointment).
Dose of medicine is based on child’s weight (1 kg = 2.2 lb)
Child dose should not exceed adult dose
|
|
Child Dose |
Adult Dose |
|
Amoxicillin |
50 mg/kg |
2000 mg |
For patients allergic to penicillin, one of the following medicines will be prescribed by your doctor:
|
Azithromycin or Clarithromycin |
15 mg/kg |
500 mg |
(2 hours before the procedure)
|
Clindamycin |
20 mg/kg |
600 mg |
|
Cephalexin or Cefadroxil |
50 mg/kg |
2000 mg |
Do not use if immediate-type hypersensitivity reaction to penicillin
For Children or Adults Unable to take Medicine by Mouth
One of the following medicines given by IV (intravenous) or IM (intramuscular) injection will be prescribed by your doctor.
Dose should be completed 30 minutes before the procedure.
Dose of Medicine is based on the child’s weight (1 kg = 2.2 lb)
Child dose should not exceed adult dose
|
|
Child Dose |
Adult Dose |
|
Ampicillin |
50 mg/kg |
2000 mg |
For children allergic to penicillin, one of the following medicines will be prescribed by your doctor:
|
Clindamycin (IV only) |
20 mg/kg |
600 mg |
|
Cefazolin (IV or IM) |
50 mg/kg |
1000 mg |
Spanish version is HFFY #5764
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 03/04/2010
Copyright © 2/2006 University of Wisconsin Hospitals and Clinics Authority, Madison, WI. All rights reserved. Produced by the Department of Nursing. UWH #4882.
Print Health Fact For You