[Fulfillment of the prevention of endocarditis guidelines after percutaneous closure of atrial septal defects].
BACKGROUND
After the implantation of an intracardiac device for the closure of an atrial septal defect, most centres follow the guidelines for antibiotic prophylaxis to reduce the risk of infectious endocarditis, at least during the first 6 months after the implantation, if there is no evidence of residual shunt. The aim of this report is to evaluate the knowledge, fulfillment and adherence to the recommendations of our centre on the prevention of endocarditis, of the families of patients subjected to percutaneous closure of an ASD.


METHODS
We performed an observational retrospective study of 51 paediatric patients subjected to percutaneous closure of an ASD in the "Complejo Hospitalario Universitario de La Coruña", between 1999 and 2008.


RESULTS
A total of 51 procedures were performed, with an average of follow-up of 57.2 months. 75.7% of the families knew about the prophylaxis of endocarditis. This percentage was higher if less time had passed since the intervention and was also higher depending on the educational level of the parents. A total of 50% never stopped carrying out the endocarditis prophylaxis. In this case, a relationship was also observed, with the educational level of the parents and with the time passed since the intervention (P=0.004). The majority (73%) of the patients never had to carry out endocarditis prophylaxis.


CONCLUSIONS
The latest guidelines on antibiotic prophylaxis of endocarditis are increasingly restrictive in their indications in order to promote a more rational use of antibiotics. More studies are needed on the indications of antibiotic prophylaxis in endocarditis in patients with an intracardiac device, in order to establish concrete or evidence-based guidelines. Meanwhile, it is our responsibility to avoid the indiscriminate application of antibiotics, and involve the families and other health professionals.
Avila Alvarez
A
A
Unidad de Cardiología Infantil, Complejo Hospitalario Universitario, A Coruña, España. alexavila81@hotmail.com
Marcos-Alonso
S
S
Rueda Núñez
F
F
Abelleira Pardeiro
C
C
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004697:Endocarditis, Bacterial / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D010290:Parents; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents