Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study

Objective To quantify the change in prescribing of antibiotic prophylaxis before invasive dental procedures for patients at risk of infective endocarditis, and any concurrent change in the incidence of infective endocarditis, following introduction of a clinical guideline from the National Institute...

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Bibliographic Details
Published in:BMJ 2011-05, Vol.342 (7807), p.1136-1136
Main Authors: Thornhill, Martin H, Dayer, Mark J, Forde, Jamie M, Corey, G Ralph, Chu, Vivian H, Couper, David J, Lockhart, Peter B
Format: Article
Language:English
Subjects:
Acute Disease
Administration, Oral
Amoxicillin
Amoxicillin - administration & dosage
Anti-Bacterial Agents - administration & dosage
Antibiotic Prophylaxis
Antibiotics
Clindamycin
Clindamycin - administration & dosage
Clinical guidelines
Clinical trials
Codes
Death
Dental treatments
Dentists
Drugs: Cardiovascular System
Endocarditis
Endocarditis - prevention & control
England
Financial risk
Guidelines
Heart
Hospitalization
Hospitals
Humans
Population
Population studies
Practice Guidelines as Topic
Prescribing
Prophylaxis
Prostheses
Recommendations
Streptococcus infections
Trends
Citations: Items that cite this one
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Summary:Objective To quantify the change in prescribing of antibiotic prophylaxis before invasive dental procedures for patients at risk of infective endocarditis, and any concurrent change in the incidence of infective endocarditis, following introduction of a clinical guideline from the National Institute for Health and Clinical Excellence (NICE) in March 2008 recommending the cessation of antibiotic prophylaxis in the United Kingdom.Design Before and after study.Setting England.Population All patients admitted to hospital in England with a primary or secondary discharge diagnosis of acute or subacute infective endocarditis.Main outcome measures Monthly number of prescriptions for antibiotic prophylaxis consisting of a single 3 g oral dose of amoxicillin or a single 600 mg oral dose of clindamycin, and monthly number of cases of infective endocarditis, infective endocarditis related deaths in hospital, or cases of infective endocarditis with a possible oral origin for streptococci.Results After the introduction of the NICE guideline there was a highly significant 78.6% reduction (P
ISSN:0959-8138
0959-535X
1468-5833
1756-1833
DOI:10.1136/bmj.d2392