YHOVN 2 năm trước

dự phòng viêm nội tâm mạc nhiễm khuẩn

Patient Category	Drug/Dosage	Time in Relation to Procedure
Dental/Oral/Respiratory Tract or Esophageal Procedures
Oral Penicillin tolerant	Amoxicillin 2 g PO	1 h preprocedure
Penicillin allergic	Azithromycin or Clarithromycin 500 mg POor Clindamycin 600 mg PO or Cephalexin or Cefadroxil 2.0 g	1 h preprocedure 1 h preprocedure 1 h preprocedure
Parenteral Penicillin tolerant	Ampicillin 2.0 g IV/IM	Within 30 min preprocedure
Penicillin allergic	Vancomycin 1.0 g or Clindamycin 600 mg IV or Cefazolin 1.0 g	Slowly over 1 h starting preprocedure Within 30 min preprocedure Within 30 min preprocedure
Genitourinary or Gastrointestinal (Excluding Esophageal) Procedures
Parenteral High Riska Penicillin tolerant	Ampicillin 2 g IV/IM + gentamicin 1.5 mg/kg IV/IM (not to exceed 120 mg) followed 6 h later by Ampicillin 1 g IV/IM or Amoxicillin 1 g PO	Within 30 min preprocedure and follow-up 6 h post 1st dose
Penicillin allergic	Vancomycin 1 g IV over 1-2 h + gentamicin 1.5 mg/kg IV (not to exceed 120 mg)—complete infusions within 30 min of starting procedure	Complete within 30 min preprocedure
Parenteral Moderate Risk
Penicillin tolerant	Ampicillin 2 g IV/IM	Within 30 min preprocedure
Penicillin allergic	Vancomycin 1 g IV over 1-2 h	Within 30 min preprocedure
Oral Moderate Risk	Amoxicillin 2 g PO	1 h preprocedure
IM, intramuscular, IV, intravenous; PO, by mouth aHigh risk: prosthetic valve, history of endocarditis, surgically constructed systemic/pulmonary shunts or conduits (Adapted from Dajani AS et al. Prevention of bacterial endocarditis: recommendations by the American Heart Association. JAMA 1997;277:1794-1801.)