Low-risk patients (no prosthetic valves or previous attack of endocarditis):
• amoxycillin 3 g (50 mg/kg up to adult dose) orally, 1 hour beforehand (if not on long-term penicillin), then 1.5 g (o) at 6 hours or
• (amoxy) ampicillin 1 g (50 mg/kg up to adult dose) IV just before procedure commences or IM 30 minutes before if having a general anaesthetic, followed by 500 mg, 6 hours later.
If hypersensitive to penicillin: vancomycin or teicoplanin or clindamycin.
High-risk patients (prosthetic valves or previous attacks of endocarditis), having dental procedures, oral surgery or upper respiratory tract surgery, GIT or GU surgery, cardiac catheterisation or temporary pacemaker insertion:
• (amoxy) ampicillin 1 g IV or IM (as above) with 500 mg, 6 hours later plus
• gentamicin 1.5 mg/kg (2.5 mg/kg in children to maximum dose 80 mg) IV (just before) or IM (30 minutes before).
If hypersensitive to penicillin: vancomycin or teicoplanin plus gentamicin.
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.