Research suggests that NICE guidance has helped to cut down on unnecessary antibiotic prescribing for the prevention of infective endocarditis. Antibiotics have been offered routinely for more than 50 years as a preventative measure to people at risk of infective endocarditis.
However, 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, in March 2008, NICE advised that antibiotic prophylaxis should no longer be offered routinely for patients at risk of infective endocarditis undergoing dental and a wide range of other invasive procedures. Researchers, 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. In order to compare more stable periods of prescribing for antibiotic prophylaxis, the 12 months before the introduction of the guideline was compared with the most recent 12 months of prescribing data. This resulted in a 78.6% reduction in antibiotic prescribing following the launch of the NICE guidelines. The reduction in antibiotic use did not cause an increase in cases of infective endocarditis or in the number of deaths from the disease.
