10 years with congenital hears disease came for extraction lower 1st molar m the AB choice for prevention of infective endocarditic is?
- A. Ampicelline 30 mg/kg orally 1 hour before procedure... IM/IV
- B. Cephalixine 50 mg/kg orally 1 hour before procedure ( if allergic to amox/ampi)
- C. Clindamicine 20 mg/kg orally 1 hour before procedure... IV
- D. Amoxicillin 50 mg/kg orally 1 hour before procedure***
The answer is D. Amoxicillin 50 mg/kg orally 1 hour before procedure*.
Here's why:
- Congenital heart disease:
This patient has a pre-existing medical condition that puts them at risk for infective endocarditis.
- Lower 1st molar extraction:
This procedure involves manipulating the gingiva and underlying tissues, which can lead to bacteremia (bacteria entering the bloodstream).
- Antibiotic prophylaxis:
To prevent infective endocarditis, antibiotic prophylaxis is recommended before dental procedures.
- Amoxicillin:
This is the antibiotic of choice for most patients with congenital heart disease who are undergoing dental procedures. It is effective against most bacteria that can cause infective endocarditis and has a good safety profile.
- Dosage and timing:
The recommended dosage is 50 mg/kg orally 1 hour before the procedure.
Therefore, D. Amoxicillin 50 mg/kg orally 1 hour before procedure is the most appropriate choice for this patient.
Here's a breakdown of the other options:
A. Ampicillin 30 mg/kg orally 1 hour before procedure... IM/IV:
Ampicillin is less effective than amoxicillin against some bacteria that can cause infective endocarditis.
B. Cephalixine 50 mg/kg orally 1 hour before procedure (if allergic to amox/ampi):
Cephalexin is a good alternative for patients who are allergic to amoxicillin or ampicillin. However, it is not as effective against some bacteria that can cause infective endocarditis.
C. Clindamicine 20 mg/kg orally 1 hour before procedure... IV:
Clindamycin is not the first-line antibiotic for infective endocarditis prophylaxis. It is usually reserved for patients who are allergic to penicillin and cephalosporins.
It's important to note that this is just a general guideline and the best course of treatment should be determined by a healthcare professional on a case-by-case basis.
