Medical Emergencies · single question
What antibiotic prophylaxis is required for a patient with a history of deep vein thrombosis?
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Correct answer: A. None is indicated
- A. CORRECT. NO antibiotic prophylaxis is indicated. Deep vein thrombosis is a VENOUS THROMBOTIC condition, not a cardiac or prosthetic condition predisposing to bacterial endocarditis. The relevant dental consideration is entirely different — it concerns ANTICOAGULATION (warfarin, apixaban, rivaroxaban) and therefore BLEEDING RISK, which is managed by checking INR where applicable and using local hemostatic measures rather than by giving antibiotics.
- B. Cephalexin is likewise an alternative for patients who require prophylaxis, which does not include a history of deep vein thrombosis.
- C. Clindamycin is a penicillin-allergy alternative in patients who genuinely require prophylaxis; this patient requires none. (Note that current AHA guidance now favors cephalosporins, azithromycin, or doxycycline over clindamycin.)
- D. Amoxicillin prophylaxis applies to the specific AHA-defined cardiac conditions: prosthetic valves, previous infective endocarditis, certain congenital heart disease, and cardiac transplant with valvulopathy.
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