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Pharmacology · single question

A patient with a prosthetic heart valve requires antibiotic prophylaxis. What is the standard FIRST-LINE regimen?

  1. Clindamycin 600mg orally 1 hour before
  2. Amoxicillin 2g orally 30-60 minutes before the procedure
  3. Azithromycin 500mg orally 1 hour before
  4. Ampicillin 2g IM/IV 30 minutes before
Show answer and explanation

Correct answer: B. Amoxicillin 2g orally 30-60 minutes before the procedure

Per AHA guidelines, prosthetic cardiac valves are high-risk and require prophylaxis. First-line = Amoxicillin 2g PO 30-60 min before.
  • A. Clindamycin 600mg is the alternative for PENICILLIN-ALLERGIC patients — not first-line for those who can take amoxicillin.
  • B. CORRECT. Amoxicillin 2g orally 30-60 minutes before the dental procedure is the standard first-line prophylaxis for high-risk cardiac patients (prosthetic valves, previous IE, specific congenital heart disease) per AHA 2007 guidelines.
  • C. Azithromycin 500mg is a second-tier alternative for penicillin-allergic patients who cannot take clindamycin.
  • D. Ampicillin IV/IM is used when the patient cannot take oral medications, not as standard first-line.

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