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Table 5. Prophylactic Regimens for Genitourinary/Gastrointestinal (Excluding Esophageal) Procedures²²

Situation Agents1 Regimen2 High-risk patients Ampicillin plus gentamicin Adults: ampicillin 2.0 g IM or IV plus gentamicin 1.5 mg/kg (not to exceed 120 mg) within 30 min of starting procedure; 6 h later, ampicillin 1 g IM/IV or amoxicillin 1 g orally Children: ampicillin 50 mg/kg IM or IV (not to exceed 2.0 g) plus gentamicin 1.5 mg/kg within 30 min of starting the procedure; 6 h later, ampicillin 25 mg/kg IM/IV or amoxicillin 25 mg/kg orally High-risk patients allergic to ampicillin/amoxicillin Vancomycin plus gentamicin Adults: vancomycin 1.0 g IV over 1-2 h plus gentamicin 1.5 mg/kg IV/IM (not to exceed 120 mg); complete injection/infusion within 30 min of starting procedure Children: vancomycin 20 mg/kg IV over 1-2 h plus gentamicin 1.5 mg/kg IV/IM; complete injection/infusion within 30 min of starting procedure Moderate-risk patients Amoxicillin or ampicillin Adults: amoxicillin 2.0 g orally 1 h before procedure, or ampicillin 2.0 g IM/IV within 30 min of starting procedure Children: amoxicillin 50 mg/kg orally 1 h before procedure, or ampicillin 50 mg/kg IM/IV within 30 min of starting procedure Moderate-risk patients allergic to ampicillin/amoxicillin Vancomycin Adults: vancomycin 1.0 g IV over 1-2 h complete infusion within 30 min of starting procedure Children: vancomycin 20 mg/kg IV over 1-2 h; complete infusion within 30 min of starting procedure

IM indicates intramuscularly, and IV, intravenously.

¹ Total children’s dose should not exceed adult dose.

² No second dose of vancomycin or gentamicin is recommended.

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