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Pulmonary Arteriovenous Fistulae Medication

  • Author: Barry A Love, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
 
Updated: Jan 29, 2015
 

Medication Summary

Drug therapy is not currently a component of the standard of care for pulmonary arteriovenous malformations (PAVMs).

Patients with pulmonary arteriovenous malformations should be given antibiotic prophylaxis before dental and surgical procedures to prevent seeding of the pulmonary arteriovenous malformation and the subsequent development of a cerebral abscess.

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Antibiotics, prophylactic

Class Summary

Antibiotic prophylaxis is given to patients before performing procedures that may cause bacteremia.

Amoxicillin (Amoxil, Trimox)

 

Interferes with synthesis of cell wall mucopeptides during active multiplication, resulting in bactericidal activity against susceptible bacteria. Used as prophylaxis in minor procedures.

Ampicillin (Marcillin, Omnipen)

 

For prophylaxis in patients undergoing dental, PO, or respiratory tract procedures. Coadministered with gentamicin for prophylaxis in GI or GU procedures.

Clindamycin (Cleocin)

 

Used in penicillin-allergic patients undergoing dental, PO, or respiratory tract procedures. Useful for treatment against streptococcal and most staphylococcal infections.

Gentamicin (Garamycin)

 

Aminoglycoside antibiotic for gram-negative coverage. Used in combination with both an agent against gram-positive organisms and one that covers anaerobes. Used in conjunction with ampicillin or vancomycin for prophylaxis in GI or GU procedures.

Vancomycin (Vancocin)

 

Potent antibiotic directed against gram-positive organisms and active against Enterococcus species. Useful in the treatment of septicemia and skin structure infections. Indicated for patients who cannot receive or have failed to respond to penicillins and cephalosporins or have infections with resistant staphylococci. Use creatinine clearance to adjust dose in renal impairment. Used in conjunction with gentamicin for prophylaxis in penicillin-allergic patients undergoing GI or GU procedures.

Erythromycin base (EES, E-Mycin, Eryc)

 

Used for prophylaxis in penicillin-allergic patients undergoing dental, PO, or respiratory tract procedures.

Cefazolin (Ancef)

 

First-generation semisynthetic cephalosporin that arrests bacterial cell wall synthesis, inhibiting bacterial growth. Primarily active against skin flora, including Staphylococcus aureus.

Cephalexin (Keflex)

 

First-generation cephalosporin that arrests bacterial growth by inhibiting bacterial cell wall synthesis. Bactericidal activity against rapidly growing organisms. Primary activity against skin flora and used for skin infections or prophylaxis in minor procedures.

Cefadroxil (Duricef)

 

First-generation cephalosporin arrests bacterial growth by inhibiting bacterial cell wall synthesis. Bactericidal activity against rapidly growing organisms. Primary activity against skin flora and used for skin infections or prophylaxis in minor procedures.

Azithromycin (Zithromax)

 

Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

Clarithromycin (Biaxin)

 

Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

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Contributor Information and Disclosures
Author

Barry A Love, MD Assistant Professor , Department of Medicine, Division of Cardiology, Assistant Professor, Division Pediatric Cardiology, Director, Pediatric Electrophysiology Service, Department of Pediatrics, Division of Pediatric Cardiology, Mount Sinai School of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Nao Sasaki, MBBS Assistant Professor of Clinical Pediatrics, University of Miami, Leonard M. Miller School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Alvin J Chin, MD Emeritus Professor of Pediatrics, University of Pennsylvania School of Medicine

Alvin J Chin, MD is a member of the following medical societies: American Association for the Advancement of Science, Society for Developmental Biology, American Heart Association

Disclosure: Nothing to disclose.

Chief Editor

Howard S Weber, MD, FSCAI Professor of Pediatrics, Section of Pediatric Cardiology, Pennsylvania State University College of Medicine; Director of Interventional Pediatric Cardiology, Penn State Hershey Children's Hospital

Howard S Weber, MD, FSCAI is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, Society for Cardiovascular Angiography and Interventions

Disclosure: Received income in an amount equal to or greater than $250 from: St. Jude Medical.

Additional Contributors

Charles I Berul, MD Professor of Pediatrics and Integrative Systems Biology, George Washington University School of Medicine; Chief, Division of Cardiology, Children's National Medical Center

Charles I Berul, MD is a member of the following medical societies: American Academy of Pediatrics, Heart Rhythm Society, Cardiac Electrophysiology Society, Pediatric and Congenital Electrophysiology Society, American College of Cardiology, American Heart Association, Society for Pediatric Research

Disclosure: Received grant/research funds from Medtronic for consulting.

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Mucosal telangiectasias are shown in a patient with hereditary hemorrhagic telangiectasia (HHT).
Left lower lobe arteriovenous malformation (AVM).
Lateral radiograph showing a left lower lobe arteriovenous malformation (AVM).
Large left lower lobe arteriovenous malformation (AVM) showing a feeding vessel to the left atrium.
Another view of the infused CT scan of the left lower lobe arteriovenous malformation (AVM).
Pulmonary angiographic findings are required not only to confirm the diagnosis but also to plan therapeutic embolization.
Small arteriovenous malformations (AVMs) in the right and left lower lobes.
Lateral radiograph shows a left lower lobe arteriovenous malformation (AVM).
Contrast-enhanced CT scan showing a left lower lobe arteriovenous malformation (AVM).
Right lower lobe arteriovenous malformation (AVM).
CT scan obtained after coil embolotherapy.
Left lower lobe embolotherapy performed at the same sitting as the coil embolotherapy depicted in the previous image.
 
 
 
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