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NICE guidance cuts antibiotic use by three quarters

Prescribing fell by 78.6% for use for infective endocarditis

Jo Carlowe

Friday, 06 May 2011

Antibiotic prescribing has been cut by three-quarters following guidance from the National Institute for Health and Clinical Excellence.

According to the new findings, prophylaxis prescribing fell by 78.6 per cent following the introduction of NICE guidelines for infective endocarditis.

Antibiotics have been offered routinely for more than 50 years as a preventative measure to people at risk of infective endocarditis, however NICE reports that there is little evidence to support this practice and any benefits from antibiotic prophylaxis need to be weighed against the risks of adverse effects for the patient and of developing antibiotic resistance.

As a result, NICE recommended in March 2008 that antibiotic prophylaxis should no longer be offered routinely for all patients at risk of infective endocarditis undergoing dental and a wide range of other invasive procedures.

Researchers, led by Professor Martin Thornhill, from the University of Sheffield, School of Clinical Dentistry, decided to assess the impact of the NICE guidelines by studying national prescribing data in England, as well as data recorded for all inpatient hospital activity in the UK.

They found that in the 12 months after the introduction of the NICE guideline, the prescribing of antibiotic prophylaxis for infective endocarditis declined rapidly.

The reduction in antibiotic use did not cause an increase in cases of infective endocarditis or in the number of deaths from the disease.

Writing in the British Medical Journal, the researchers say that the decrease in prescribing of antibiotics in the months after the introduction of the guideline was large and suggests much better compliance than is often seen after policy changes in medicine, with particularly good compliance among dentists.

They concluded that the findings “support the cessation of antibiotic prophylaxis before dental and other invasive procedures.”

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