A 24-year-old woman with a repaired cyanotic congenital heart disease and a prosthetic patch is scheduled for dental extraction. She is not allergic to penicillin. What prophylactic antibiotic regimen is recommended?

• A Amoxicillin 2 g orally 30 to 60 minutes before the procedure ✓
• B Amoxicillin 500 mg orally 6 hours before the procedure
• C Gentamicin 120 mg intravenously during the procedure
• D Vancomycin 1 g orally immediately after the procedure

Explanation

For dental procedures in high-risk patients, the standard regimen is a single oral dose of amoxicillin 2 g (50 mg/kg in children) given 30 to 60 minutes before the procedure. Patients allergic to penicillin receive azithromycin 500 mg, clarithromycin 500 mg, clindamycin 600 mg, or cephalexin 2 g instead. Vancomycin is not absorbed orally, and post-procedure dosing provides no benefit since bacteraemia peaks during the procedure.

Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.