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

Objective-To estimate the cumulative exposure to bacteraemia from dental pr ocedures currently recommended for antibiotic prophylaxis and compare this with cumulative exposure from dental procedures not recommended for prophyl axis. Design-Retrospective analysis. Setting-University and teaching hospital maxillofacial and dental departmen t. Patients-136 children with severe congenital cardiac disease attending for dental treatment between 1993 and 1998 and for whom full records were avail able. Each dental procedure was tallied. Main outcome measures-Cumulative exposure per annum to "non-prophylaxis pro cedures"; cumulative exposure per annum to "prophylaxis procedures". Results-Cumulative exposure to bacteraemia from prophylaxis procedures was nor 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.