The Incidence of Infective Endocarditis in England is….ppt

The Incidence of Infective Endocarditis in England is Increasing An Assessment of the Impact of Cessation of Antibiotic Prophylaxis Using Population Statistics Dr Mark Dayer, Taunton and Somerset NHS Trust, UK Professor Simon Jones, University of Surrey, UK Dr Bernard Prendergast, John Radcliffe Hospital, UK Professor Larry Baddour, Mayo Clinic, USA Professor Peter Lockhart, Carolinas Medical Centre, USA Professor Martin Thornhill, University of Sheffield, UK Historical Perspective ?1955: First AHA Guidelines on AP ?essive guidelines have tended to mend: –Smaller doses of antibiotics given for a shorter time –That fewer patients regarded as being at risk of IE –Fewer invasive procedures covered ?Increasing controversy over time ?No randomized trial of AP UK NICE Guidelines: March 2008 NICE - March 2008 Antibiotic prophylaxis against infective endocarditis is not mended: ?For people undergoing dental procedures ?For people undergoing non-dental procedures at the following sites: –Upper and lower gastrointestinal tract –Genitourinary tract –Upper and lower respiratory tract Funded opportunity to study the impact of stopping antibiotic prophylaxis at a national level Methodology ?England only - ~ 50m ?All prescriptions for single doses of amoxicillin 3g or clindamycin 600mg ?Jan 1 st 2004 – March 31 st 2013 ?Patients discharged from English hospitals with a primary diagnosis of infective endocarditis ?Jan 1 st 2000 – March 31 st 2013 ?Superspells ?19,804 cases in total Antibiotic Prophylaxis Prescribing Data NICE guideline s Number of Prescriptions of Amoxicillin 3g or Clindamycin 600mg Average pre: 10,900 Average final 6m: 1,307 Reduction: 88%, p< Incidence of IE Incidence of Infective Endocarditis Cases (Superspells) and Deaths / 10 Million / Month