Management of medical emergencies in the dental office

Management of Medical Emergencies Antibiotic Prophylaxis

• 06/26/22

• Prophylactic Regimen for Dental Procedures
• Unable to take Oral Medication
• Ampicillin
• Adults: 2 gr IM or IV
• Children: 50 mg/kg IM or IV
• Within 30 minutes of procedure

Management of Medical Emergencies Antibiotic Prophylaxis

• 06/26/22

• Amoxicillin vs. Penecillin
• Both equally effective against Streptococus viridan
• Amoxicillin is better absorbed from the GI tract, and provides higher and more sustained serum level
• 2 gr. Provides as effective coverage as 3 gr. With less GI adverse effects.
• 2nd dosage not required due to prolonged serum level above the inhibitory period for most oral Streptococci.

Management of Medical Emergencies Antibiotic Prophylaxis

• 06/26/22

• ERYTHROMYCIN
• No longer recommended due to GI side effects. Practitioners who have used it successfully in the past, may continue to use it following the previously published regimen.
• 2 gr. 2 hours before procedure
• 1 gr. 6 hours later

Management of Medical Emergencies Antibiotic Prophylaxis

• 06/26/22

• Patient already taking antibiotic used for prophylaxis:
• Select an antibiotic from a different class, rather than increasing the dosage
• Delay treatment if possible 9 to 14 days after completion of antibiotic to allow usual flora to reestablish
• Example: Amoxicillin, go to Clindamycin.
• No Cephalosporin due to cross resistance

Management of Medical Emergencies Antibiotic Prophylaxis

• 06/26/22

• Prophylaxis for dental patients with
• TOTAL JOINT REPLACEMENT