Neue Empfehlungen zur Antibiotischen Endokarditisprophylaxe: Pädiatrische Applikation

Infective endocarditis in childhood is still associated with considerable morbidity and mortality. Based on the new Swiss guidelines for prophylaxis, paediatric cardiologists have worked out a consensus which is presented in this place. Special attention is paid to the difference between paediatrics and adult medicine concerning prophylaxis. Furthermore the reasons why extreme caution is needed in childhood are shown. In addition to the propositions in the new guidelines the Swiss Society of Paediatric Cardiology recommend antibiotic endocarditis prophylaxis for unoperated acyanotic heart defects with a risk of endothelial lesions (aortic valve lesions and VSD). In childhood, endocarditis prophylaxis covers meticulous dental hygiene and selective antibiotic therapy if there is a risk of bacteraemia. Overtreatment, that is giving broad spectrum antibiotics for viral infections or fever of unknown origin has to be avoided. To evaluate the new “guidelines” and potential further modifications a prospective data collection of paediatric endocarditis cases in Switzerland is mandatory.