Key result
The introduction of guidelines restricting antibiotic prophylaxis before invasive procedures was temporally associated with a significant increase in infective endocarditis incidence.
Why the study?
Does antibiotic prophylaxis prevent infective endocarditis in at-risk patients undergoing invasive procedures?
Does antibiotic prophylaxis prevent infective endocarditis in at-risk patients undergoing invasive procedures?
The introduction of restrictive guidelines for infective endocarditis prophylaxis was followed by a significant increase in IE incidence, suggesting a potential need to re-evaluate current recommendations.
Shifting IE risk factors may prompt prophylaxis reassessment; Level 5 data leave open the need for prospective validation.
The most obvious changes over time have been in terms of factors that lead to IE. For e.g. A larger elderly population, decrease in Rheumatic heart disease (RHD) cases, Increased use of prosthetic heart valves, increased intravenous drug abuse, and increased rates of intravascular catheter-induced nosocomial infections. Antibiotic prophylaxis has been recommended for invasive procedures such as dental extractions, genito-urinary procedures and gastrointestinal procedures, in those who have pre-disposing cardiac conditions.
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Nikita Carvalho (2019) conducted a review in Infective endocarditis. Restriction of antibiotic prophylaxis guidelines vs. Prior permissive antibiotic prophylaxis guidelines was evaluated. The introduction of guidelines restricting antibiotic prophylaxis before invasive procedures was temporally associated with a significant increase in infective endocarditis incidence.
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