Please see the link below for the latest prescribing advice for antibiotic cover for at risk patients for endocarditis

https://www.antibioticprophylaxis.sdcep.org.uk/implementation-advice/prescribing-advice/

If you receive an 404 error message with the above link please copy and paste the link below into your browser OR alternatively you can hit the home page button on the error 404 to take you back to the main page and guidance section.
https://www.antibioticprophylaxis.sdcep.org.uk/implementation-advice/prescribing-advice/

Further Detail
Provide the patient with a prescription for antibiotic prophylaxis at the appointment prior to the planned procedure unless you hold a supply of antibiotics in your practice.

If a patient’s cardiac team suggests an alternative prophylaxis regimen, it is acceptable to follow their advice but ensure that the reasons for this are recorded in the patient’s clinical notes.
For patients who require sequential ‘at-risk’ dental procedures (see 'At-risk' dental procedures) over a short time period, and it has been agreed that prophylaxis is appropriate, the same antibiotic can be prescribed for each treatment episode. In this situation, the AHA suggests a delay of 10 days between procedures that require antibiotic prophylaxis.23
For a patient who has received a recent course of antibiotics for a medical or dental infection, it is not necessary to select a drug from a different antibiotic class for the prophylaxis prescription.
If the antibiotic regimens included in this implementation advice are unsuitable, contact an expert, such as a consultant microbiologist or community pharmacist, for advice on an alternative drug regimen. The UK Dental Medicines Advisory Service can also offer advice be contacted for advice.
Give advice on possible side effects (e.g. nausea, diarrhoea) and other adverse events (e.g. hypersensitivity, anaphylaxis and antibiotic-related colitis).

Patients prescribed an antibiotic should be advised to seek urgent medical attention if they develop antibiotic-associated colitis (severe diarrhoea, which can be fatal). The risk of colitis is increased in vulnerable groups (e.g. older age, frailty, immunosuppressed), those who have received prolonged or repeated course of antibiotics and those with a history of gastrointestinal disease.
Arrange for the antibiotic to be taken in the practice 30-60 minutes before the planned procedure is due to commence.

If you do not hold a supply of antibiotics in your practice, advise the patient to bring the prescribed antibiotic with them to the dental practice on the day of the procedure and ensure that the patient remains in the practice in the interval between taking the antibiotic and the start of treatment.
Alternatively, if the patient expresses a preference to take the antibiotic at home or at another location outside the practice, and has not previously had an adverse reaction to prophylaxis, it is acceptable to agree to this. Consider advising they contact the practice prior to taking the antibiotic to confirm that the procedure will be going ahead.