I have no concerns but would like to add the following caveat:
1. I was expert witness on a case where the dental professional administered amoxicillin prophylaxis to a patient with MVP without prolapse, with a documentation from the patient's physician indicating that, in his opinion, prophylaxis is necessary even though the guidelines recommended against it. The patient anaphylaxed and unfortunately died in the dental office. BOTH the dentist and the physician were sued. The case was eventually settled, after considerable amount of finger-pointing.
If I were you, I would retreat to the "I'm just a dentist" routine, indicate that the prophylaxis is not according to guidelines, indicate that you would be much more comfortable if the physician writes the prophylaxis prescription, and carefully document your thought process in the chart.
2. Although there is a regimen for IV ampicillin, it is designed exclusively for patients who cannot take po. You are correct that you would be able to get Ampicillin into the blood stream relatively promptly with IV administration. However, oral amoxicillin is very rapidly absorbed and you would get reasonable level of antibiotics in within 20 minutes of administration. In France, many patients get chairside amoxicillin. The new recommendations suggest 30-60 minutes prior to the procedure. In sum, you can do it, but it is probably not necessary in the majority of instances
Les
lesfang
