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Trends in endocarditis hospitalizations at US children's hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines.

Publication ,  Journal Article
Pasquali, SK; He, X; Mohamad, Z; McCrindle, BW; Newburger, JW; Li, JS; Shah, SS
Published in: Am Heart J
May 2012

BACKGROUND: In 2007, the American Heart Association recommended cessation of antibiotic prophylaxis for infective endocarditis (IE) before dental procedures for all but those at highest risk for adverse outcomes from IE. The impact of these guidelines is unclear. We evaluated IE hospitalizations at US children's hospitals during this period. METHODS: Children <18 years old hospitalized from 2003 to 2010 with IE at 37 centers in the Pediatric Health Information Systems Database were included. Using Poisson regression, we evaluated the number IE hospitalizations over time (raw and indexed to total hospital admissions). RESULTS: A total of 1157 IE cases were identified; 68% had congenital heart disease (CHD). The raw number of IE cases did not change significantly over time (+1.6% difference post vs pre guidelines, 95% CI -6.4% to +10.3%, P = .7). When the number of IE cases was indexed per 1,000 hospital admissions, there was a significant decline during the time period before the guidelines (annual change: -5.9%, 95% CI -9.9 to -1.8, P = .005) and a similar decline in the post guidelines period such that the difference between the 2 periods was not significant (P = .15). In subgroup analysis, no significant change over time in IE cases (raw or indexed) was found in the CHD subset, those 5 to 18 years old (subgroup most likely receiving dental care), or in cases coded as oral streptococci. CONCLUSIONS: We found no evidence that release of new antibiotic prophylaxis guidelines was associated with a significant change in IE admissions across 37 US children's hospitals.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

May 2012

Volume

163

Issue

5

Start / End Page

894 / 899

Location

United States

Related Subject Headings

  • United States
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Practice Guidelines as Topic
  • Male
  • Infant
  • Incidence
 

Citation

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ICMJE
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Pasquali, S. K., He, X., Mohamad, Z., McCrindle, B. W., Newburger, J. W., Li, J. S., & Shah, S. S. (2012). Trends in endocarditis hospitalizations at US children's hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines. Am Heart J, 163(5), 894–899. https://doi.org/10.1016/j.ahj.2012.03.002
Pasquali, Sara K., Xia He, Zeinab Mohamad, Brian W. McCrindle, Jane W. Newburger, Jennifer S. Li, and Samir S. Shah. “Trends in endocarditis hospitalizations at US children's hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines.Am Heart J 163, no. 5 (May 2012): 894–99. https://doi.org/10.1016/j.ahj.2012.03.002.
Pasquali SK, He X, Mohamad Z, McCrindle BW, Newburger JW, Li JS, et al. Trends in endocarditis hospitalizations at US children's hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines. Am Heart J. 2012 May;163(5):894–9.
Pasquali, Sara K., et al. “Trends in endocarditis hospitalizations at US children's hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines.Am Heart J, vol. 163, no. 5, May 2012, pp. 894–99. Pubmed, doi:10.1016/j.ahj.2012.03.002.
Pasquali SK, He X, Mohamad Z, McCrindle BW, Newburger JW, Li JS, Shah SS. Trends in endocarditis hospitalizations at US children's hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines. Am Heart J. 2012 May;163(5):894–899.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

May 2012

Volume

163

Issue

5

Start / End Page

894 / 899

Location

United States

Related Subject Headings

  • United States
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Practice Guidelines as Topic
  • Male
  • Infant
  • Incidence