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18 November 2014

NICE to review its guidance on the use of antibiotics to prevent infective endocarditis

NICE has announced it is to review immediately its 2008 guideline which recommended that antibiotics should not be prescribed to prevent infective endocarditis. The review will focus on new research published today at a meeting of the American Heart Association in Chicago. It suggests the number of people developing the potentially fatal condition has increased following publication of NICE’s guidance.

Infective endocarditis is a potentially fatal infection of the endocardium (heart lining), particularly the heart valves.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: “We will immediately look in detail at data published today that shows an increase in the number of cases of infective endocarditis. However, as the authors of the study acknowledge, it’s far from clear if there is a link between the rise in cases and publication of the NICE guidance in 2008 recommending that people at risk of infective endocarditis should not be prescribed prophylactic antibiotics.

“For example, the incidence of infective endocarditis had been going up even before our guidance was published and the reasons for this are still not known. It’s also unclear why the increase in the number of cases has not been matched by a corresponding increase in the number of deaths.

“But where new evidence has called into question the safety of current guidance, it is right that we review that guidance as quickly as possible.


“We will explore thoroughly the new data and assess what impact, if any, it will have on our guidance. In doing so we will need to consider what is the balance between any potential benefits in increasing antibiotic prophylaxis and potential risks of increasing anaphylaxis and antibiotic resistance. Importantly, we will also look at what other factors could be accounting for the rise in the number of people being diagnosed with infective endocarditis. In the meantime the current NICE guidance should continue to be followed.”  


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