title: Antibiotic Prophylaxis of Infective Endocarditis.
abstract: Links between infective endocarditis (IE) and dental and other invasive procedures were first identified in the 1920s, and the use of antibiotic prophylaxis (AP) to prevent IE was first recommended by the American Heart Association in 1955. Recognising the weak evidence to support this practice and the wider risks of anaphylaxis and antibiotic resistance, guidelines in the USA and Europe have been rationalised in the last decade with restriction of AP to those patients perceived to be at the highest risk. In the UK, the National Institute for Health and Care Excellence controversially recommended the complete cessation of AP for all invasive procedures in 2008 and subsequent epidemiological studies have suggested a significant increase in cases above the baseline trend. AP appears to be safe and is likely to be cost-effective. Until further data are available, we recommend continued adherence to US and European guidelines.
authors.affiliation: Department of Oral & Maxillofacial Medicine and Surgery, University of Sheffield School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA, UK. m.thornhill@sheffield.ac.uk.|Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA. m.thornhill@sheffield.ac.uk.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Thornhill
authors.affiliation: Taunton and Somerset NHS Trust, Taunton, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Dayer
authors.affiliation: Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Lockhart
authors.affiliation: Guy's and St Thomas' Hospitals, London, UK.
authors.forename: Bernard
authors.initials: B
authors.lastname: Prendergast
keywords: Antibiotic prophylaxis; Endocardium infection; Infective endocarditis