Prophylaxis of Dental Procedures in Immunocompromised Patients

  • The risk of sepsis following dental procedures in immunocompromised patients should not be much higher than the general population.
  • Certain conditions that may be associated with increased risk of infection include but are not limited to: neutropenia and neutrophil dysfunction, severe malnourishment, poorly controlled diabetes, and certain haematologic malignancies/disorders.

For these conditions recommend:

 

Antibiotic Adult Dose Paediatric Dose
amoxicillin 2g PO x 1 dose 30-60 min before 50 mg/kg (max 2g) PO x 1 dose 30-60 min before
Penicillin/amoxicillin allergy  
cefuroxime axetil
500mg PO x 1 dose 30-60 min before 10mg/kg (max 500mg) PO x 1 dose 30-60 min before
Cefuroxime allergy
azithromycin
500mg PO x 1 dose 30-60 min before 15mg/kg (max 500mg) PO x 1 dose 30-60 min before
or    
clarithromycin 500mg PO x 1 dose 30-60 min before 15mg/kg (max 500mg) PO x 1 dose 30-60 min before
or    
doxycycline 100mg PO x 1 dose 30-60 min before

< 45 kg:  2.2mg/kg PO x 1 dose 30-60 min before

   

> 45 kg:  100mg PO x 1 dose 30-60 min before