Time-trend population analysis of the clinical and epidemiologic effect on pediatric infective endocarditis after change of antibiotic prophylaxis guidelines

• Published in: Infection 2020-10, Vol.48 (5), p.671-678
• Main Authors: Knirsch, Walter, Schuler, Stefanie Katharina, Christmann, Martin, Weber, Roland
• Format: Article
• Language: English
• Subjects: Adolescent; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis - statistics & numerical data; Child; Child, Preschool; Endocarditis - drug therapy; Endocarditis - epidemiology; Endocarditis - microbiology; Endocarditis - mortality; Family Medicine; Female; General Practice; Guidelines as Topic; Humans; Incidence; Infant; Infant, Newborn; Infectious Diseases; Internal Medicine; Male; Medicine; Medicine & Public Health; Original Paper; Prevalence; Switzerland - epidemiology
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-020-01433-4

Purpose In 2007, antibiotic prophylaxis (AP) guidelines for infective endocarditis (IE) changed, but the possible influence on the annual incidences of pediatric IE is unclear. Methods We studied the clinical and epidemiologic impact of AP change by comparing two time periods before and after change of AP guidelines in a tertiary care center as referral center for a total population of more than 4,500,000 inhabitants. Results After change of AP guidelines, twenty-five patients were diagnosed for IE at a median age of 6.9 years (range 0.1–19.4, female 48%). Modified Duke criteria were fulfilled for definite (12/25; 48%), or probable IE (13/25; 52%). The frequency of IE (cases per 1000 hospitalized patients) increased from 0.37% (1995–2005) to 0.59% (2006–2017) [ p  = 0.152], the annual incidence of IE (cases per 1000 CHD patients,