Children who have a patent ductus arteriosus (as well as those with certain other congenital heart defects) need to receive antibiotic treatment before going to the dentist or undergoing any invasive procedure. Dental procedures, especially those in which bleeding is anticipated, put these children at risk for a condition called Subacute Bacterial Endocarditis, which is a condition in which the heart becomes infected with bacteria.

h3. I. Standard general prophylaxis for patients at risk:

Amoxicillin: Adults, 2.0 g (children, 50 mg/kg) given orally one hour before procedure.

h3. II. Unable to take oral medications:

Ampicillin: Adults, 2.0 g (children 50 mg/kg) given IM (injection) or IV within 30 minutes before procedure.

h3. III. Amoxicillin/ampicillin/penicillin allergic patients:

Clindamycin: Adults, 600 mg (children 20 mg/kg) given orally one hour before procedure. -OR-
Cephalexin* or Cefadroxil*: Adults, 2.0 g (children 50 mg/kg) orally one hour before procedure. -OR-
Azithromycin or Clarithromycin: Adults, 500 mg (children 15 mg/kg) orally one hour before procedure.

h3. IV. Amoxicillin/ampicillin/penicillin allergic patients unable to take oral medications:

Clindamycin: Adults, 600 mg (children 20 mg/kg) IV within 30 minutes before procedure. -OR-
Cefazolin*: Adults, 1.0 g (children 25 mg/kg) IM or IV within 30 minutes before procedure.

*Cephalosporins should not be used in patients with immediate-type hypersensitivity reaction to penicillins.

Revised 3.22.09