Pharmacology · single question
A patient with MVP (no history of infective endocarditis) and penicillin allergy needs a surgical extraction of tooth 5. What is the most appropriate first choice for antibiotic prophylaxis?
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Correct answer: C. No antibiotics are indicated
Per the 2007 AHA/ADA guidelines (still current), MITRAL VALVE PROLAPSE WITHOUT a history of infective endocarditis does NOT require antibiotic prophylaxis before dental procedures. The updated guidelines significantly narrowed prophylaxis indications. Only patients with: previous infective endocarditis, prosthetic cardiac valves, specific congenital heart conditions, or cardiac transplant with valve disease require prophylaxis. Simple MVP = NO antibiotic prophylaxis needed.
- A. INCORRECT. Azithromycin 500mg would be the alternative for penicillin-allergic patients IF prophylaxis were indicated — but it's not indicated for uncomplicated MVP.
- B. INCORRECT. Cephalexin 2g is the first choice for penicillin-allergic patients without IgE-mediated reactions IF prophylaxis is indicated — but MVP alone does not qualify.
- C. CORRECT. Mitral valve prolapse WITHOUT a history of infective endocarditis does NOT require antibiotic prophylaxis according to the 2007 AHA guidelines. No antibiotics are indicated for this patient.
- D. INCORRECT. Amoxicillin prophylaxis is not indicated for MVP without history of IE, and the patient has a penicillin allergy.