Antibiotic Prophylaxis for Congenital Cardiac Catheterizations: Lessons Learned From the Pediatric Health Information System

Bayan Issa; Kamel Shibbani; Isabella Zaniletti; Matt Hall; Henri Justino; Howaida El-Said; Brent M Gordon

doi:10.1016/j.jacadv.2026.102969

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Antibiotic Prophylaxis for Congenital Cardiac Catheterizations: Lessons Learned From the Pediatric Health Information System

Journal article

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Peer reviewed

Antibiotic Prophylaxis for Congenital Cardiac Catheterizations: Lessons Learned From the Pediatric Health Information System

Bayan Issa, Kamel Shibbani, Isabella Zaniletti, Matt Hall, Henri Justino, Howaida El-Said and Brent M Gordon

JACC. Advances (Online), Vol.5(8), 102969

07/09/2026

DOI: 10.1016/j.jacadv.2026.102969

PMID: 42431094

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Abstract

Background There is significant antibiotic prophylaxis (ABP) variability before congenital cardiac catheterization procedures. The true incidence of procedure-related infective endocarditis (IE) remains unclear. Objective This study aimed to evaluate national periprocedural ABP utilization patterns and determine whether ABP dosing strategies are associated with early postprocedural IE. Methods A retrospective cohort study was conducted using data from the Pediatric Health Information System from 39 pediatric centers. Data were collected on the following procedures: patent ductus arteriosus (PDA) device occlusion, atrial septal defect device occlusion, ventricular septal defect device occlusion, transcatheter pulmonary valve replacement (TPVR), and pulmonary or aortic balloon valvuloplasty. Outcomes assessed were: 1) rate and pattern of periprocedural antibiotic use and 2) incidence of early IE within 30-days postprocedure. Results A total of 20,580 procedures were analyzed. Antibiotic dosing varied significantly by procedure, with the proportion of patients receiving ≥2 doses ranging from 38.8% for PDA closure to 85.7% for TPVR. A total of 15 IE cases (0.07%) were identified within 30 days, more than half of which followed TPVR (53%). The incidence of early IE varied significantly by procedure type ( P = 0.003): TPVR (0.27%), pulmonary valvuloplasty (0.12%), atrial septal defect closure (0.04%), and PDA closure (0.02%). There was no measurable association between ABP and early IE. Conclusions Procedure-related IE is exceedingly rare and is significantly related to procedure type. We did not observe a measurable association between early IE and ABP dosing. These findings underscore the need for standardized, evidence-based guidelines to optimize antibiotic protocols for congenital cardiac catheterization.

Congenital Heart Disease

ventricular septal defect device occlusion

infective endocarditis

transcatheter pulmonary valve replacement

cardiac catheterization

antibiotic prophylaxis

patent ductus arteriosus

atrial septal defect

Details

Title: Subtitle: Antibiotic Prophylaxis for Congenital Cardiac Catheterizations: Lessons Learned From the Pediatric Health Information System
Creators: Bayan Issa - Rady Children's Hospital-San Diego
Kamel Shibbani - University of Iowa
Isabella Zaniletti - Children's Hospital Association
Matt Hall - Children's Hospital Association
Henri Justino - Rady Children's Hospital-San Diego
Howaida El-Said - Rady Children's Hospital-San Diego
Brent M Gordon - Rady Children's Hospital-San Diego
Resource Type: Journal article
Publication Details: JACC. Advances (Online), Vol.5(8), 102969
DOI: 10.1016/j.jacadv.2026.102969
PMID: 42431094
NLM abbreviation: JACC Adv
ISSN: 2772-963X
eISSN: 2772-963X
Publisher: Elsevier
Language: English
Date published: 07/09/2026
Academic Unit: Cardiology; Stead Family Department of Pediatrics
Record Identifier: 9985180787802771

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