A child with established rheumatic heart disease involving the mitral valve is about to undergo dental extraction. Which antibiotic regimen is recommended for endocarditis prophylaxis?
- A Penicillin V 250 mg twice daily for 5 days
- B Amoxicillin 50 mg/kg orally 1 hour before the procedure ✓
- C Benzathine penicillin G IM on the day of the procedure
- D No prophylaxis required; RHD is not an indication
Correct answer: B. Amoxicillin 50 mg/kg orally 1 hour before the procedure
Explanation
Patients with rheumatic heart disease involving valvular damage are in the high-risk group for infective endocarditis, and AHA guidelines recommend endocarditis prophylaxis with amoxicillin 50 mg/kg (maximum 2 g) orally 30–60 minutes before high-risk dental procedures. Benzathine penicillin is used for secondary prophylaxis against streptococcal pharyngitis to prevent recurrent ARF, which is a different indication. Clindamycin is used if penicillin-allergic.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.