Recently, a new version of the American Heart Association guidelines for bacterial endocarditis prophylaxis was published.1 These recommendations include a traditional list of procedures that do not require prophylaxis, on account of the low incidence of subsequent bacteremia.2 Circumcision is included in this list for the first time, but no references are cited. To the best of our knowledge, the appropriate approach to the newborn with congenital heart disease who is facing circumcision has never been discussed in the literature. As practicing pediatricians specializing in pediatric infectious diseases (Y.S.) and circumcision (J.U.), we are frequently consulted on this issue. Hence, we would like to briefly review the rationale behind the new recommendations.
Schlesinger Y, Urbach J. Circumcision and Endocarditis Prophylaxis. Arch Pediatr Adolesc Med. 1998;152(4):412. doi: