Is prophylaxis against bacerial endocarditis warranted in circumcision?

ABSTRACT

The occurrence of bacteremia during oro-dental manipulation and surgical procedures with subsequent development of endocarditis after bacteremia is well established. However, the prevalence of bacteremia and thus the necessity of endocarditis prophylaxis after circumcision is not yet settled. To further clarify this issue, blood cultures in one hundred normal 2-5 year-old boys who underwent circumcision were examined pre-operatively, immediately and/or 15 minutes after surgery. A positive blood culture for Staphylococcus aureus was found in only two children, neither of whom developed signs or symptoms of bacteremia or sepsis. In a retrospective chart review over a ten-year period of 85 male patients with endocarditis and 51 male cases of septicemia, circumcision was not found to be a predisposing factor for bacterial endocarditis and sepsis. We believe that in patients with structural heart disease, endocarditis prophylaxis for circumcision, is not warranted