Dental procedures in children with severe congenital heart disease: A theoretical analysis of prophylaxis and non-prophylaxis procedures

Abstract

Objective - To estimate the cumulative exposure to bacteraemia from dental procedures currently recommended for antibiotic prophylaxis and compare this with cumulative exposure from dental procedures not recommended for prophylaxis. Design - Retrospective analysis. Setting - University and teaching hospital maxillofacial and dental department. Patients - 136 children with severe congenital cardiac disease attending for dental treatment between 1993 and 1998 and for whom full records were available. Each dental procedure was tallied. Main outcome measures - Cumulative exposure per annum to "non-prophylaxis procedures"; cumulative exposure per annum to "prophylaxis procedures". Results - Cumulative exposure to bacteraemia from prophylaxis procedures was not significantly greater than from non-prophylaxis procedures. Conclusions - The data raise important questions about the appropriateness of current guidelines for antibiotic prophylaxis of bacterial endocarditis.