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Medical Emergencies · single question

A 14-year-old with Down syndrome had an atrial septal defect (ASD) successfully repaired. Is antibiotic prophylaxis required before dental treatment?

  1. Azithromycin 500mg orally
  2. Amoxicillin 500mg orally
  3. No prophylaxis needed
  4. Amoxicillin 2g orally 1 hour before
Show answer and explanation

Correct answer: C. No prophylaxis needed

  • A. ❌ Azithromycin is the alternative for penicillin-allergic patients — prophylaxis is not indicated at all in this case.
  • B. ❌ 500mg amoxicillin is an incorrect dose for prophylaxis and is not indicated here.
  • C. ✅ Correct. Per AHA guidelines: Successfully repaired congenital heart defects with NO residual shunt and NO prosthetic material do NOT require antibiotic prophylaxis after the first 6 months post-repair. A successfully repaired ASD = NO prophylaxis.
  • D. ❌ 2g amoxicillin is the standard dose for high-risk conditions, but is NOT indicated for a successfully repaired ASD without residual defect.

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