Medcert.com ABIM Board Exam Pearls & Study Tips.
Antibiotic prophylaxis questions used to be difficult and confusing (and easy to get wrong), but thankfully the current recommendations are very straight forward. The board will put a bunch of confounding (superficially scary) cardiac histories and exam points, and lead you to “want” to give antibiotic prophylaxis, but don’t be fooled!! If whatever they put doesn’t fall in the categories below, PLEASE. . . just say no.
- Prosthetic heart valve
- History of infective endocarditis
- Congenital heart disease issues:
(1) unrepaired cyanotic congenital disease, including palliative shunts and conduits
(2) completely repaired congenital heart defect with prosthetic material or device during the first 6 months after the procedure
(3) repaired congenital disease with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device
- Transplantation recipients with cardiac valvular disease
So the reverse of this is. . . if you have a repaired congenital heart defect, and its after 6 months, no matter how dysfunctional the defect was, and all has been well recently, don’t give prophylaxis.