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Endocarditis prevention: time for a review of NICE guidance.
Thornhill, Martin; Prendergast, Bernard; Dayer, Mark; Frisby, Ash; Baddour, Larry M.
Afiliación
  • Thornhill M; Unit of Oral & Maxillofacial Medicine, Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
  • Prendergast B; Guy's and St Thomas' Hospital, London and Chair of Cardiology, Cleveland Clinic, London, UK.
  • Dayer M; Somerset NHS Foundation Trust, Somerset, UK.
  • Frisby A; Patient Advocate, London, UK.
  • Baddour LM; Division of Public Health, Infectious Diseases and Occupational Health, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
Lancet Reg Health Eur ; 39: 100876, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38481485
ABSTRACT
In 2023, the European Society of Cardiology (ESC) updated its infective endocarditis (IE) guidelines strongly endorsing antibiotic prophylaxis (AP) before invasive dental procedures (IDPs) for high-risk patients, elevating their recommendation to Class I. The American Heart Association (AHA) is aligned with this view and reaffirmed the need for AP to prevent IE in those at high-risk in its 2021 guidelines. In contrast, the UK's National Institute for Health and Care Excellence (NICE) recommends against routine AP use. Despite considerable new evidence, NICE has not reviewed this recommendation since 2015. In this Personal View, we review the new evidence that has arisen since 2015. Our analysis establishes the association between IDPs and IE and shows that AP is both safe and effective in reducing the IE-risk following IDPs in those at high-risk. Data also show that AP is cost-effective and would result in significant cost savings and health benefits if re-introduced into the UK's National Health Service for high-risk patients. Given these insights, we argue it is time NICE reviewed its guidance so that high-risk patients in the UK receive the same protection against IE that is afforded to patients in the rest of the world.

Funding:

The authors received no specific funding for this work.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Lancet Reg Health Eur Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Lancet Reg Health Eur Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido