| Dental, Oral, Respiratory Tract, or Esophageal Procedures |
|
| SITUATION | ADULT REGIMEN | CHILDREN'S REGIMEN (Total children's dose should not exceed adult dose) |
| Standard general prophylaxis | Amoxicillin 2 g 1 h before procedure | Amoxicillin 50 mg/kg orally 1 h before procedure |
| Unable to take oral meds | Ampicillin 2 g I.M./I.V. within 30 min before procedure | Ampicillin 50 mg/kg I.M./I.V. within 30 min before procedure |
| Allergic to penicillin | Clindamycin 600 mg 1 h before procedure
--or--
Cephalexin or cefadroxil 2 g 1 h before procedure
--or--
Azithromycin or clarithromycin 500 mg 1 h before procedure | Clindamycin 20 mg/kg orally 1 h before procedure
--or--
Cephalexin or cefadroxil 50 mg/kg orally 1 h before procedure
--or--
Azithromycin or clarithromycin 15 mg/kg orally 1 h before procedure |
| Unable to take oral meds and allergic to penicillin | Clindamycin 600 mg IV within 30 min before procedure
--or--
Cefazolin 1 g IV/IM within 30 min before procedure | Clindamycin 20 mg/kg IV within 30 min before procedure
--or--
Cefazolin 25 mg/kg IV/IM within 30 min before procedure |
| -- | -- | -- |
| Genitourinary/Gastrointestinal (Excluding Esophageal) Procedures |
|
| SITUATION | ADULT REGIMEN | CHILDREN'S REGIMEN (Total children's dose should not exceed adult dose) |
| High Risk Patients | Ampicillin 2 g I.M. or I.V. plus gentamicin 1.5 mg/kg (not to exceed 120 mg) within 30 min of starting the procedure; 6 h later, ampicillin 1 g I.M./I.V. or amoxicillin 1 g orally | Ampicillin 50 mg/kg I.M./I.V. (not to exceed 2 g) plus gentamicin 1.5 mg/kg within 30 min of starting the procedure; 6 h later, ampicillin 25 mg/kg I.M./I.V. or amoxicillin 25 mg/kg orally |
| High-risk patients allergic to ampicillin/amoxicillin | Vancomycin 1 g I.V. over 1-2 h plus gentamicin 1.5 mg/kg I.M./I.V. (not to exceed 120 mg); complete injection/infusion within 30 min of starting the procedure | Vancomycin 20 mg/kg I.V. over 1-2 h plus gentamicin 1.5 mg/kg I.M./I.V.; complete injection/infusion within 30 min of starting the procedure |
| Moderate Risk Patients | Amoxicillin 2 g orally 1 h before procedure, or ampicillin 2 g I.M./I.V within 30 min of starting the procedure | Amoxicillin 50 mg/kg orally 1 h before procedure, or ampicillin 50 mg/kg I.M./I.V. within 30 min of starting the procedure |
| Moderate-risk patients allergic to ampicillin/amoxicillin | Vancomycin 1 g I.V. over 1-2 h; complete infusion within 30 min of starting the procedure | Vancomycin 20 mg/kg I.V. over 1-2 h; complete infusion within 30 min of starting the procedure |