Infective Endocarditis Prophylaxis — EECC MCQ
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Correct answer: A — Amoxicillin 2 g orally 30-60 minutes before the procedure
A prosthetic aortic valve places this patient in the high-risk cardiac group for infective endocarditis. Dental extraction is an at-risk dental procedure because it involves gingival/periapical manipulation and bacteraemia risk. Current UK dental implementation advice aligned with NICE CG64 recommends offering antibiotic prophylaxis for high-risk patients before extractions/oral surgery. With no penicillin allergy and able to take oral medication, the regimen is a single dose of amoxicillin 2 g orally 30–60 minutes before the procedure. Therefore the correct answer is A. Clindamycin is not the preferred UK prophylaxis option, IV cefazolin after the procedure is incorrectly timed and not indicated here, and azithromycin would only be an alternative in penicillin allergy and as a single prophylactic dose, not 250 mg daily for 3 days.
Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Antibiotic Prophylaxis Against Infective Endocarditis: Implementation Advice, 2nd edition, March 2026. https://www.antibioticprophylaxis.sdcep.org.uk/implementation-advice/executive-summary/executive-summary/