hopeofglory87
Forum Senior
Topics: 23
Posts: 71
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7. A 5-year-old girl with ventricular septal defect is scheduled for tonsillectomy in 2 weeks. She has no known drug allergies. Her temperature is 37 C (98.6 F). Examination shows no abnormalities. Which of the following is the most appropriate prophylaxis prior to tonsillectomy?
A
) Amoxicillin
B
) Ciprofloxacin
C
) Rifampin
D
) Tetracycline
E
) Trimethoprim-sulfamethoxazole
F
) No prophylaxis indicated
I think it's F
since they revised the prophylaxis recommendations
Is F right?
Antibiotic prophylaxis, if 100% effective, likely prevents only a small number of cases of endocarditis; nevertheless, it is possible that rare cases are prevented. Weighing the potential benefits, potential adverse events, and costs associated with antibiotic prophylaxis, the expert committee of the American Heart Association has dramatically restricted the recommendations for antibiotic prophylaxis. Prophylactic antibiotics (Table 118-7) are advised only for those patients at highest risk for severe morbidity or death from endocarditis (Table 118-8). Prophylaxis is recommended only for dental procedures wherein there is manipulation of gingival tissue or the periapical region of the teeth or perforation of the oral mucosa (including surgery on the respiratory tract). Although prophylaxis is not advised for patients undergoing gastrointestinal or genitourinary tract procedures, it is recommended that effective treatment be given to these high-risk patients before or when they undergo procedures on an infected genitourinary tract or on infected skin and related soft tissue. Maintaining good dental hygiene is also advised. (For further details, see http://www.americanheart.org/presenter.jhtml?iden....)
High risk patients
- Prosthetic heart valves
- Prior endocarditis
- Unrepaired cyanotic congenital heart disease, including palliative shunts or conduits
- Completely repaired congenital heart defects during the 6 months after repair
- Incompletely repaired congenital heart disease with residual defects adjacent to prosthetic material
- Valvulopathy developing after cardiac transplantation
harrison 17th ed
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| nightflight1945
banned
Topics: 32
Posts: 920
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THANKS!
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| nightflight1945
banned
Topics: 32
Posts: 920
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Yes , it is F!
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| hopeofglory87
Forum Senior
Topics: 23
Posts: 71
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yup! I think it;s F too
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| Rweda
Forum Newbie
Topics: 1
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 what?! Since when did somebody with vsd undergo surgery without prophylactic antibiotics?
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| hopeofglory87
Forum Senior
Topics: 23
Posts: 71
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this year~ ^^;;
check this out
http://www.americanheart.org/presenter.jhtml?iden...
It's changed very recently
It's in Harrison's 17th ed.
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