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A 19-year-old Caribbean woman is admitted to the gynecology service because of an ectopic pregnancy. She has a history of bacterial endocarditis. She is allergic to penicillin. In addition to her left lower quadrant pain and fever, her physical exam is significant for a grade III/VI diastolic murmur. Blood pressure is 120/80 mm Hg. The EKG is normal, and the echocardiogram shows mitral stenosis with no visible vegetations. What is your recommendation for antibiotic prophylaxis prior to surgically removing the ectopic pregnancy?
(A) Vancomycin and gentamicin
(B) Amoxicillin
© Clindamycin
(D) Ampicillin and gentamicin
(E) No antibiotics indicated
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A bcoz patient is allergic to penicillin
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E) according to new concepts no need any antibiotics for any OB/GYN procedures
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its not because of ob/gyn procedure but past h/o endocarditis requires prophylaxis(even new concept)...
the ans shud be macrolide if pencillin allergic, but not in option so, go with AAA...
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TABLE 6. Summary of Major Changes in Updated Document
We concluded that bacteremia resulting from daily activities is much more
likely to cause IE than bacteremia associated with a dental procedure.
We concluded that only an extremely small number of cases of IE might be
prevented by antibiotic prophylaxis even if prophylaxis is 100% effective.
Antibiotic prophylaxis is not recommended based solely on an increased
lifetime risk of acquisition of IE.
Limit recommendations for IE prophylaxis only to those conditions listed in
Table 3.
Antibiotic prophylaxis is no longer recommended for any other form of CHD,
except for the conditions listed in Table 3.
Antibiotic prophylaxis is recommended for all dental procedures that involve
manipulation of gingival tissues or periapical region of teeth or perforation of
oral mucosa only for patients with underlying cardiac conditions associated
with the highest risk of adverse outcome from IE (Table 3).
Antibiotic prophylaxis is recommended for procedures on respiratory tract or
infected skin, skin structures, or musculoskeletal tissue only for patients
with underlying cardiac conditions associated with the highest risk of
adverse outcome from IE (Table 3).
Antibiotic prophylaxis solely to prevent IE is not recommended for GU or GI
tract procedures.
The writing group reaffirms the procedures noted in the 1997 prophylaxis
guidelines for which endocarditis prophylaxis is not recommended and
extends this to other common procedures, including ear and body piercing,
tattooing, and vaginal delivery and hysterectomy.
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so what is the answer
is it EEEEEEEEEEEEEEEEEEE?
