UK Drop in Antibiotic Prophylaxis Linked To Increased Number of Heart Infections Interview with:
Dr. Martin Thornhill PhD

Department of Cardiology, Taunton and Somerset NHS Trust
Taunton, Somerset, UK

Medical Research: What is the background for this study? What are the main findings?

Dr. Thornhill: In 2008 NICE introduced controversial new guidance recommending that antibiotic prophylaxis to prevent infective endocarditis should no longer be used. It was a rational decision, given the evidence for the effectiveness of antibiotic prophylaxis and potential concerns about costs, the development of antibiotic resistance and possible side effects from antibiotics, but it went against other guidelines from around the world that existed at the time.

The main findings are that in England:

  1. There has been a large and significant decline in the use of antibiotic prophylaxis.
  2. There has been a significant increase in the number of cases of infective endocarditis, above the baseline trend, using hospital coding data, corrected for changes in the size of the English population.

Medical Research: What should clinicians and patients take away from your report?

Dr. Thornhill: We cannot conclude, just because there is correlation, that the change in practice has resulted in a change in the incidence of infective endocarditis. Clinicians and patients should not change their practice at present, but should wait for further analysis of the data by guideline committees.

Incidence of infective endocarditis in England, 2000–13: a secular trend, interrupted time-series analysis
Mark J Dayer PhD,Prof Simon Jones PhD,Bernard Prendergast FRCP,Prof Larry M Baddour MD,Prof Peter B Lockhart DDS,Prof Martin H Thornhill PhD
The Lancet – 18 November 2014
DOI: 10.1016/S0140-6736(14)62007-9

Last Updated on November 24, 2014 by Marie Benz MD FAAD