A 59-year-old man is evaluated at a dental clinic prior to undergoing a root canal procedure. His BMI is 45. There is a 2/6 decrescendo holodiastolic murmur auscultated on cardiac examination. Blood pressure is 140/60. Echocardiography confirms the diagnosis. Which of the following is the most appropriate next step in preoperative management?
A) Amoxicillin orally 2 grams
B) Cefoxitin orally
C) No preoperative antibiotics indicated
D) Vancomycin + ceftriaxone
E) Vancomycin + gentamicin
