Infective Endocarditis Prophylaxis Flashcards

High-Risk Conditions (Prophylaxis Indicated)

Q: What are the HIGH-risk conditions requiring IE prophylaxis (2024)? A: Prosthetic valves, prior IE, unrepaired cyanotic CHD, repaired CHD with residual defect adjacent to prosthetic material, cardiac transplant with valvulopathy Tags: ie-prophylaxis, high-risk, high-yield

Q: Does a repaired ASD require IE prophylaxis? A: No - unless repaired with prosthetic material AND has residual defect at the repair Tags: ie-prophylaxis, asd

Q: Does a repaired VSD require IE prophylaxis? A: Only if residual defect adjacent to prosthetic patch material Tags: ie-prophylaxis, vsd

Q: How long after complete repair of CHD is prophylaxis needed? A: Only first 6 months after repair with prosthetic material (if no residual defect) Tags: ie-prophylaxis, timing, high-yield

Q: Does mitral valve prolapse require IE prophylaxis? A: No (changed from older guidelines) Tags: ie-prophylaxis, mvp

Q: Does hypertrophic cardiomyopathy require IE prophylaxis? A: No Tags: ie-prophylaxis, hcm

Q: Does bicuspid aortic valve require IE prophylaxis? A: No (unless prosthetic valve placed) Tags: ie-prophylaxis, bav

Procedures Requiring Prophylaxis

Q: What dental procedures require IE prophylaxis in high-risk patients? A: Procedures involving manipulation of gingival tissue, periapical region, or perforation of oral mucosa Tags: ie-prophylaxis, dental, high-yield

Q: Does teeth cleaning require IE prophylaxis? A: Yes - involves gingival manipulation Tags: ie-prophylaxis, dental

Q: Does routine dental exam without cleaning require prophylaxis? A: No Tags: ie-prophylaxis, dental

Q: Do respiratory procedures (bronchoscopy, intubation) require prophylaxis? A: Only if incision/biopsy of respiratory mucosa Tags: ie-prophylaxis, respiratory

Q: Do GI/GU procedures require IE prophylaxis? A: No - NOT recommended (changed from older guidelines) Tags: ie-prophylaxis, gi-gu, high-yield

Q: Does colonoscopy require IE prophylaxis? A: No Tags: ie-prophylaxis, gi

Antibiotic Regimens

Q: What is the standard prophylaxis regimen for dental procedures? A: Amoxicillin 50 mg/kg (max 2g) PO 30-60 minutes before procedure Tags: ie-prophylaxis, regimen, high-yield

Q: What is the regimen for penicillin-allergic patients? A: Azithromycin 15 mg/kg (max 500mg) OR Clindamycin 20 mg/kg (max 600mg) PO Tags: ie-prophylaxis, pcn-allergy

Q: What is the regimen for patients unable to take oral medications? A: Ampicillin 50 mg/kg (max 2g) IV/IM OR Cefazolin 50 mg/kg (max 1g) IV/IM Tags: ie-prophylaxis, iv-regimen

Q: If prophylaxis is inadvertently missed, can it be given after procedure? A: Yes - within 2 hours of procedure Tags: ie-prophylaxis, timing

Clinical Pearls

Q: What type of IE is prophylaxis designed to prevent? A: Viridans group streptococcal endocarditis (from oral flora) Tags: ie-prophylaxis, pathogen

Q: Why was prophylaxis for GI/GU procedures removed from guidelines? A: No evidence of benefit; IE from these organisms rare; resistance concerns Tags: ie-prophylaxis, rationale

Q: What should high-risk patients carry with them? A: Card indicating their condition and need for prophylaxis Tags: ie-prophylaxis, patient-education