This Appropriate Use Criteria goes as far as stating whether or not prophylactic antibiotics may be appropriate for a particular patient profile. These antibiotic dosage recommendations are provided as an additional resource and based solely on the 2007 statement released by the American Heart Association. The only adjustments from the original statement are the removal of Clindamycin and Cefazolin as antibiotic options. This change is based on more recently published evidence (see tool disclaimer)
Cross reactivity of cephalosporin antibiotics in patients with penicillin allergy is 5% for first generation drugs, and 1% for third generation drugs, so these drugs should be used unless there is a history of anaphylaxis with penicillin administration. If there is a concern, patients should be referred for allergy testing prior to administering antibiotic prophylaxis.
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