New Study Examines Incidence of Infective Endocarditis After Prophylaxis Guideline Modifications

A study released on May 21 in the Journal of the American College of Cardiology found that reducing antibiotic prophylaxis indications did not contribute to an increased occurrence of oral streptococcal infective endocarditis (IE).

The study, "Temporal Trends in Infective Endocarditis in the Context of Prophylaxis Guideline Modifications: Three Successive Population-based Surveys," looked to evaluate temporal trends in IE following 2002 French guideline modifications that recommended restricting the indications of antibiotic prophylaxis of IE.

The study is based on three, one-year population-based surveys of 11 million people age 20 and older from three regions in France in 1991, 1999 and 2008. Despite the general improvement in patients’ medical care, IE prognosis did not improve between 1991 and 2008, and the in-hospital mortality rate remained as high as 20 percent. It also found an increase of staphylococcal IE in a population of patients not identified as at-risk for IE.

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"Despite marked modifications of IE prophylaxis recommendations between 1999 and 2008 toward a reduction of antibiotic use … this fact should prompt a decrease in the unnecessary consumption of antibiotics, a source of ever-increasing bacterial resistance," study authors noted. In addition, the study recommends focusing on avoidance of Staphylococcus aureus bacteremia in all patients, including those with no previously known valve disease, in order to improve IE prevention.

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