title: Trends in infective endocarditis hospitalisations at United States children's hospitals from 2003 to 2014: impact of the 2007 American Heart Association antibiotic prophylaxis guidelines.
abstract: OBJECTIVE
  National organisations in several countries have recently released more restrictive guidelines for infective endocarditis prophylaxis, including the American Heart Association 2007 guidelines. Initial studies demonstrated no change in infective endocarditis rates over time; however, a recent United Kingdom study suggested an increase; current paediatric trends are unknown.
  
  
  METHODS
  Children (5 years of age. Interrupted time series analysis was used to evaluate rates over time indexed to total hospitalisations.
  
  
  RESULTS
  A total of 841 cases were identified. The median age was 13 years (interquartile range 9-15 years). In the pre-guideline period, there was a slight increase in the rate of infective endocarditis by 0.13 cases/10,000 hospitalisations per semi-annual period. In the post-guideline period, the rate of infective endocarditis increased by 0.12 cases/10,000 hospitalisations per semi-annual period. There was no significant difference in the rate of change in the pre- versus post-guidelines period (p=0.895). Secondary analyses in children >5 years of age with CHD and in children hospitalised with any type of infective endocarditis at any age revealed similar results.
  
  
  CONCLUSIONS
  We found no significant change in infective endocarditis hospitalisation rates associated with revised prophylaxis guidelines over 11 years across 29 United States children's hospitals.
authors.affiliation: 1Congenital Heart Center,C.S. Mott Children's Hospital,University of Michigan Medical School,Ann Arbor,Michigan,United States of America.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Bates
authors.affiliation: 2Children's Hospital Association,Overland Park,Kansas,United States of America.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hall
authors.affiliation: 3Division of Hospital Medicine and Division of Infectious Diseases,Cincinnati Children's Hospital Medical Center,Cincinnati,Ohio,United States of America.
authors.forename: Samir S
authors.initials: SS
authors.lastname: Shah
authors.affiliation: 4Duke University Medical Center and the Duke Clinical Research Institute,Durham,North Carolina,United States of America.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Hill
authors.affiliation: 1Congenital Heart Center,C.S. Mott Children's Hospital,University of Michigan Medical School,Ann Arbor,Michigan,United States of America.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Pasquali
mesh_terms: D000293:Adolescent; D000572:American Heart Association; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002648:Child; D004696:Endocarditis / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Endocarditis; antibiotic prophylaxis; paediatrics