Children with an avulsed tooth may need antibiotic prophylaxis against bacterial endocarditis

BMJ 1996;312:1538 (15 June)

Letters

Children with an avulsed tooth may need antibiotic prophylaxis against bacterial endocarditis

EDITOR,--In their editorial on the emergency management of childrenwith an avulsed tooth Anthony S Blinkhorn and Iain C Mackiemention prophylactic antibiotics.¹ Children with a congenitalcardiac abnormality require special consideration--for example,a 10 year old with an avulsed tooth might be given amoxycillin250 mg three times daily as routine prophylaxis but requirea dose of 1.5 g if at risk of bacterial endocarditis.²

One study showed a 61% incidence of bacteraemia in childrenafter the extraction of two to four permanent teeth that werenot diseased.³ A cardiac defect is the commonest congenitalabnormality. The development of bacterial endocarditis in achild with a small ventricular septal defect may represent alife threatening complication of a previously asymptomatic abnormality.There is evidence of incomplete awareness among parents of theneed for prophylaxis against bacterial endocarditis.⁴ When presentingto an accident and emergency department with their child, parents. . . [Full text of this article]