Impact of AHA’s 2007 guideline change on incidence of infective endocarditis in infants and children

İnfektif Endokarditli Çocuklarda Klinik Özellikler, Tedavi Yaklaşımları ve Komplikasyonlar: Türkiye’den Tek Merkez Deneyimi

“…Prevention of IE via prophylaxis is a controversial issue, with the prophylaxis recommendation from the AHA's and ESC's current guidelines being limited to cardiac conditions in which the risk of IE and its complications are high (2). In a study investigating the effects of the AHA's 2007 guidelines on the incidence, clinical course, hospital stay, and mortality rate, no significant difference was found in the incidence of IE and the severity of the disease in the 5-year period after the new guidelines had been introduced but it was reported that VGS were detected in increasing frequency as the IE agent in children aged > 10 years (15). Similarly, Pant et al (16) reported an increase in the incidence of IE caused by streptococci in the post-guideline period.…”

“…Similarly, Pant et al (16) reported an increase in the incidence of IE caused by streptococci in the post-guideline period. They thought that the decrease in the use of IE prophylaxis for low-risk patients in the post-guideline period might have led to this increase (15). As a result of the increased incidence mostly occurring in older children, they emphasized that the age ranges in which patients more frequently undergo dental treatment should be taken into consideration (15).…”

“…They thought that the decrease in the use of IE prophylaxis for low-risk patients in the post-guideline period might have led to this increase (15). As a result of the increased incidence mostly occurring in older children, they emphasized that the age ranges in which patients more frequently undergo dental treatment should be taken into consideration (15). In 2008, the recommendation in the UK was to discontinue prophylaxis, including in those patients with a high risk of developing IE, and it was reported that 2 years post-recommendation, there had been no significant change in the incidence of IE, but a significant increase occurred after 5 years (17,18).…”

Patent Arterial Duct

“…Infective endocarditis due to viridans group streptococci is presumed to result principally from bacteraemia during dental work, which is more common in older children. It should be noted that the absence of overall change in infective endocarditis incidence from pre-to postguideline might in part reflect poor adherence to the 2007 AHA policy [39,40].…”

Investigation of the impact of the NICE guidelines regarding antibiotic prophylaxis during invasive dental procedures on the incidence of infective endocarditis in England: an electronic health records study

“…This was in contrast to American Heart Association (AHA) [2] and European Society of Cardiology (ESC) [3] guidelines issued around the same time, which continued to recommend antibiotic prophylaxis in certain high-risk cases, e.g., patients with prosthetic heart valves or who had had infective endocarditis previously. Although much research on the impact of guideline changes on the incidence of infective endocarditis has been conducted internationally [4][5][6][7][8][9][10][11][12][13][14][15], and in particular a study in England which showed an increase in cases following the NICE guideline change [6], no consensus has been reached, and in a 2016 update to their guidelines [16] NICE reaffirmed their previous position, while clarifying that doctors and dentists should still apply their clinical judgement on a case by case basis.…”