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+--- Thread: mcq - nimishkum (/showthread.php?tid=417057)
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mcq - nimishkum - ArchivalUser - 06-06-2009
A 48-year-old woman asks you about prophylaxis for bacterial endocarditis before a dental procedure. She has a history of mitral valve prolapse with regurgitation, which has been confirmed by echocardiography. She has a history of anaphylaxis to penicillin. Which of the following recommendations is correct?
A. Amoxicillin 2 g orally 1 hour before the procedure
B. Ciprofloxacin 500 mg orally 1 hour before the procedure
C. Clindamycin 600 mg orally 1 hour before the procedure
D. Erythromycin stearate 1 g orally 1 hour before the procedure
E. No antibiotic prophylaxis
0 - ArchivalUser - 06-06-2009
ee
0 - ArchivalUser - 06-06-2009
eee
0 - ArchivalUser - 06-06-2009
American Heart Association guidelines recommend antibiotic prophylaxis for dental procedures in patients with mitral valve prolapse with regurgitation.
now
0 - ArchivalUser - 06-06-2009
ohhhh
then clindamycin is answer
0 - ArchivalUser - 06-06-2009
hary what u say,even i m confused,any latest guidelines,even i think eeeee
0 - ArchivalUser - 06-06-2009
Latest guidelines (2007):
No longer indicated ” Common valvular lesions for which antimicrobial prophylaxis is no longer recommended in the 2007 AHA guidelines include:
- Bicuspid aortic valve,
- Acquired aortic or mitral valve disease (including mitral valve prolapse with regurgitation and those who have undergone prior valve repair), and
- Hypertrophic cardiomyopathy with latent or resting obstruction
Dental ” risk of IE is generally considered to be the highest for all dental procedures that involve manipulation of either gingival tissue or the periapical region of teeth or perforation of the oral mucosa
The AHA guideline no longer considers any GI (including diagnostic colonoscopy or esophagogastroduodenoscopy) or GU procedures high risk and therefore do not recommend routine use of IE prophylaxis even in patients with the highest risk cardiac conditions defined above
0 - ArchivalUser - 06-06-2009
CHOICE OF ANTIMICROBIAL AGENT ”
Dental, oral, or upper respiratory tract procedures ” The primary antibiotic regimen for most patients, including those with prosthetic valves, is amoxicillin, 2 g orally 30 to 60 minutes before the procedure; a second dose is not necessary
A different regimen is warranted in the following circumstances; all drugs are given 30 to 60 minutes before the procedure:
Patients who are allergic to penicillins or ampicillin can be treated with cephalexin (2 g) or azithromycin or clarithromycin (500 mg) or clindamycin (600 mg).
Patients who are unable to take oral medications can be treated with 2 g of intravenous or intramuscular ampicillin. Patients allergic to penicillin can be given cefazolin or ceftriaxone (1 g intravenously) OR 600 mg of intravenous or intramuscular clindamycin.
0 - ArchivalUser - 06-06-2009
so for dental procedures v need prophylaxis.
Good Q nimish..
0 - ArchivalUser - 06-06-2009
thanks harry..