MCW & FMLH
Antibiotic Guide

This guide was prepared by members of the Antibiotic Subcommittee of the Pharmacy and Therapeutics Committee and has been approved for use at Froedtert Hospital.

AHA Prophylaxis Guidelines
For Prevention Of Bacterial Endocardiditis

Recommended Prophylactic Regimen For Dental, Oral, Or Upper Respiratory Procedures In Patients Who Are At Risk

ConditionDrugAdult Dose
Standard regimen
  • Amoxicillin
    		• 2 g po 1 h before procedure
    Amoxicillin/penicillin allergic patients
  • Clindamycin or

  • Cephalexin or cefadroxil or

  • Azithromycin or clarithromycin
    		• 600 mg po 1 h before procedure

    2 g po 1 h before proceedue

    500 mg po 1 h before procedure
    Patients unable to take oral medication
  • Ampicillin
    		• 2 g IV/IM 30 min before procedure
    Patients unable to take oral medications and are ampicillin/amoxicillin/penicillin allergic
  • Clindamycin or


  • Cefazolin
    		• 600 mg IV 30 min before procedure

    1 g 30 min before procedure

    Regimens For Genitourinary/Gastrointestinal (excluding esophageal) Procedures

    ConditionDrugAdult Dose
    Standard regimen
  • Ampicillin

    and

    Gentamicin

    PLUS

    Amoxicillin or Ampicillin

    		• 2 g IV/IM 30 min before procedure.
    1.5 mg/kg IV/IM (maximum 80 mg) 30 min before procedure.

    1 g po 6 h after initial dose or
    1 g IV/IM 6 h after initial dose
    Ampicillin/amoxicillin/penicillin allergic patients
  • Vancomycin

    and

  • Gentamicin
    		• 1 g IV over 1-2 h completing within 30 min of starting procedure
    1.5 mg/kg IV/IM (maximum 120 mg) completing within 30 min of starting procedure
    Alternate regimen for low-risk patients
  • Amoxicillin or

  • Ampicillin
    		• 2 g po 1 h before procedure

    2 g IM/IV within 30 min of starting procedure

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    last update 6/27/2000
    WWW version maintained for the hospital P&T committee by:
    Gary P. Barnas, M.D., Office of Clinical Informatics
    send comments to: Cindy Hennen, R.Ph.