PROPHYLAXIS OF BACTERIAL-ENDOCARDITIS - A MISUNDERSTANDING AND THE CONSEQUENCES

According to a wide-spread misunderstanding prophylaxis for prevention of bacterial endocarditis in children with congenital heart defects c onsists above all in supplying antibiotics to treat viral infections o f the upper respiratory tract in order to prevent bacterial superinfec tion. How fatal this may turn out is depicted on the basis of two typi cal case reports. In both cases, the ''prophylactic'' antibiotic thera py of an erroneously presumend viral infection enabled rapid progressi on of the actually existing bacterial endocarditis. The conclusion to be drawn is the following: If there is no indication of a bacterial in fection in a febrile child with congenital heart defect, antibiotic th erapy is just as obsolete as in children without cardiac defects. Ther e is no difference in treatment of bacterial infections between childr en with and without heart disease. If the laboratory findings are indi cative of a bacterial infection in a febrile child with congenital hea rt disease, whose actual diagnosis is unclear, blood cultures have to be taken.