[Endocarditis prophylaxis in children and adolescents : implementation of the current guidelines in the Department of Paediatric Surgery at the Medical University Graz].

The timely administration of endocarditis prophylaxis means an additional stress situation for many children and their parents in an already stressful preoperative period. In addition it causes an increased organizational effort most of all in the day care department. Over many decades the use of prophylactic antibiotics to prevent infective endocarditis was recommended in patients with underlying cardiac conditions undergoing medical procedures which could lead to bacteraemia. However, transient bacteraemia occurs commonly during routine daily activities such as cleaning teeth or chewing. Most cases of endocarditis are not related to a medical procedure. There are currently no randomized and carefully controlled human trials to definitely prove the effectiveness and efficiency of endocarditis prophylaxis. Therefore, the new guidelines recommend the use of antibiotic prophylaxis only for cardiac conditions associated with the highest risk of adverse outcome from endocarditis. In paediatric surgery and paediatric anaesthesiology this applies mainly to patients with congenital heart disease. The implementation of the new guidelines in the Department of Paediatric Surgery at the Medical University Graz is illustrated in the following article.