How Have Endocarditis Prophylaxis Recommendations Changed?
After 52 years of recommending antibiotic prophylaxis coverage for all invasive dental procedures and other types of oral surgery for virtually all children with congenital heart disease, the American Heart Association (AHA) has radically reduced the indications for prophylaxis as of April 2007. Although the length of time to give antibiotics around dental surgery or oral surgery had dropped several times since the initial recommendations from 1955 up to the most recent revision in 1997, the 2007 document represents a major departure from all previous AHA recommendations. This decision was reached by an expert panel of pediatric cardiologists, pediatric infectious disease specialists, and adult cardiologists. The decision to dramatically revise the endocarditis prophylaxis guidelines was made by this large group of consultants to the AHA after an exhaustive review of the medical literature. A strict evidence-based analysis was utilized and the committee found no evidence for a Class I
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