ArticleEuropean journal of pediatrics2025
Endocarditis prophylaxis in children and adolescents: indications in consideration of the dental treatment setting.
Article in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- The organization of pediatric care: the right care, from the right professional, at the right time and place: an editorial update.European journal of pediatrics · 2026Article
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5 authors.
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Abstract
This study aimed to evaluate the administration of endocarditis prophylaxis (EP) in children and adolescents with cardiac findings requiring invasive dental therapy according to the newest European Society of Cardiology (ESC) guidelines from 2023. The research question focused on comparing EP protocols between chairside treatment (CS) and general anesthesia (GA) settings, given clinical protocol differences observed between these modalities. This retrospective analysis included 201 patients with cardiac findings who attended the Department of Pediatric Dentistry at Giessen University Hospital between 2018 and 2023 and underwent dental interventions with bacteremia risk. Patient data included cardiac findings, EP administration protocols, antibiotic agents used, treatment settings, and patient outcomes defined as infective endocarditis (IE) occurrence within three months post-intervention. EP indications were evaluated according to ESC guidelines. Fisher's exact test was used to statistically test differences (GA vs. CS) regarding the outcome and the type of EP medication (α = 0.05). Of all patients, 58.7% received treatment under GA and 41.3% chairside. According to ESC guidelines, EP indication existed in 36.4% of GA patients and 22.9% of CS patients. However, EP was administered in 84.7% of GA patients and 59.0% of CS patients. A significant correlation was found between the variables "treatment setting" and "antibiotic preparation EP" (p < 0.001). No cases of IE occurred within 3 months, regardless of EP administration or indication status.
conclusionBesides the limitations of our retrospective study, frequent EP over-administration beyond guideline recommendations was detected, and no IE cases occurred. This aspect could question whether EP indications should be more restrictively defined, particularly in children and adolescents with healthy dental status. WHAT IS KNOWN: • The indication for antibiotic endocarditis prophylaxis (EP) during dental treatment is based on cardiac and dental risk factors. • In 2023, the European Society of Cardiology (ESC) published new guidelines for the prevention of infective endocarditis (IE) [1]. WHAT IS NEW: • This study highlights the difficulties in implementing guideline-adhering endocarditis prophylaxis and emphasizes the need for strict and comprehensible EP indication in children and adolescents.
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