Andersons pediatric cardiology 1500

TheIEprophylaxisimpactstudiesdetailsaresummarizedinTable56.12.
Table56.12
StudiesonEffectof2007–2008ChangeinInfectiveEndocarditis
ProphylaxisRecommendations(2002forFrance)
PatientAge
(Adults,
Country
Children,
Mixed)
NOCHANGEINIEINCIDENCE
Pasqualiet 2002–2010 US(37
Children
al20
centers)
Duvalet
3annual:
France
Adult
al255
1991,1999, (national)
2008
DeSimone 1999–2013 US
Mixed
etal257
Mackieet 2002–2013 Canada
Mixed
al254
Guptaet
2000–2010 US
Children
al50

Bateset
2003–2014 US
Children
al258
Sakai
2001–2012 US
Children
Bizmark
etal259
INCREASEINIEINCIDENCE
Pantet
2000–2011 US
Mixed
al260
Dayeret
2000–2013 UK
Mixed
al261
Study
Reference
Period

No.of
Cases

Remark

1157

LargepediatricIEstudy

411,557,
488

Nationalstudy

—

VGSIEincidencenotincreased

8055
3840

IncreasebutchangeofslopeApril2011,
decreaseofStreptococcalIE
LargepediatricIEstudy

841

Largepediatricstudy,noIEincrease

3748

Largepediatricstudy,nodifferenceofslope
ofincrease,slightincreaseinVGSIEin10to17-year-olds

29,820–
Increase11to>15/100,000/year(increase
47,134/year VGS)
19,804

Increase

IE,Infectiveendocarditis;VGS,viridansgroupstreptococci.

StudiesontheimpactofIEprophylaxisfacethedifficultiesofadjustmentof
massivedataforchangesinvariousconfoundingfactors.Therehasbeen
adjustmentfortheincreaseintotalpopulationnumber,butitisimmensely
difficulttoadjustforthebetterrecordofcasesandforthesubstantialrisein
numberofproceduresforvalveanddeviceimplantations.
ProphylaxisCost-Effectiveness.
Arecentpaperreportedthecost-effectivenessofapotentialreintroductionofIE
prophylaxisintheUnitedKingdom.252Studiesoncost-effectivenessfacethe
difficultiesofcalculatingthepresumedhealthgains.


EndocarditisTeam
PatientswithsuspectedpediatricIEmightbestbecaredforatcenterswith
accesstoateamincludingpediatriccardiologists,clinical
microbiology/infectiousdiseasespecialists,andcardiacsurgeons.1,2These
shouldalsohaveaccesstocardiacCTandnuclearimagingincludingPET/CT,
brainCT,andMRI.Thereshouldbeaninterventionalradiologyservicefor
insertionoflong-termperipherallyinsertedcentralcathetersfortheantibiotic
treatment.Therehastobeaccesstoservicesneededtohandlecomplications
fromIE,suchasneurology,neurosurgery,vascularsurgeons,andorthopedic
surgeons.


AnnotatedReferences
AATSSurgicalTreatmentofInfectiveEndocarditis
ConsensusGuidelinesWritingCommittee

Chairs,PetterssonGB,CoselliJS,etal.2016the
Americanassociationforthoracicsurgery
(AATS)consensusguidelines:surgicaltreatment
ofinfectiveendocarditis:executivesummary.J
ThoracCardiovascSurg.2017;153(6):1241–
1258.e29.
ArecentupdateonrecommendationsforIE
surgery.
BaddourLM,WilsonWR,BayerAS,etal.
Infectiveendocarditisinadults:diagnosis,
antimicrobialtherapy,andmanagementof
complications:ascientificstatementfor
healthcareprofessionalsfromtheAmerican
heartassociation.Circulation.
2015;132(15):1435–1486.
Amust-readupdatedAmericanguidelinesforIE
management.
BaltimoreRS,GewitzM,BaddourLM,etal.
Americanheartassociationrheumaticfever,
Endocarditis,andkawasakidiseasecommitteeof
thecounciloncardiovasculardiseaseinthe
youngandthecounciloncardiovascularand