ON THE PROPHYLAXIS OF INFECTIVE ENDOCARDITIS IN PAEDIATRIC DIGESTIVE ENDOSCOPY- A FIVE YEARS RETROSPECTIVE STUDY

Abstract

Aim of the study Infective endocarditis is a lifelong risk for patients with severe cardiac malformations. The purpose of this study is to report the incidence of infective endocarditis in 3439 children that have undergone an exploratory or interventional endoscopic procedure in the “Sfanta Maria” Hospital Paediatric Diagnostic and Interventional Digestive Endoscopy Unit between 2009 and 2013. Material and methods Of all superior endoscopy cases, 96,73% of cases were performed for diagnostic purposes and 3,27% of cases necessitated an interventional procedure: oesophageal dilatation with Savary devices or foreign body extraction. Colonoscopies were performed for diagnostic purposes in 89,67% of cases and for therapeutic purposes (polyp extraction) in 10,33% of cases. Results Of the 3439 cases included in this study, only 5 cases had a post procedural complication: 2 cases of cardiorespiratory stop, 2 cases of colon perforation and 1 case of massive post polypectomy bleeding. No cases of infective endocarditis were reported. Infective endocarditis prophylaxis was performed in selected patients, according to existing recommendations. Conclusions Infective endocarditis prophylaxis is no longer routinely recommended in diagnostic endoscopic interventions, even if biopsies are performed, unless the child has a severe cardiac malformation or has undergone a reparatory cardiac procedure in the last 6 months or has a previous infective endocarditis episode. Decisions should be made in a customized manner

Keywords

• digestive endoscopy
• infective endocarditis