A new study by UK researchers at the University of Sheffield revealed that an increase in cases of infective endocarditis in the UK may be related to guidelines that recommend withholding antibiotic treatment in high-risk patients undergoing invasive dental procedures.
The study revealed that after the guidelines were enacted, the number of antibiotic prescriptions dropped by 80%. As the use of antibiotics went down, however, the rate of infective endocarditis increased by 35 more cases a month.
Infective endocarditis is a rare infection that affects the lining of the heart and is particularly hard for the immune system to fight. People who already have heart conditions face a more significant threat and have a 50% chance of dying from the infection after a year.
The National Institute for Health Care and Excellence, also known as NICE, introduced guidelines back in 2008 recommending that antibiotics not be given to patients considered to be at high risk of contracting the infection before going through invasive dental treatments. There was an average of 10,600 prescriptions for antibiotic prophylaxis given to prevent infective endocarditis between 2004 and 2008, but this number dropped to 2,236 between 2008 and 2013.
Despite the apparent relationship between the two, researchers from the study caution that the results do not prove any connection between lower antibiotic prophylaxis and the rise in the infection.
“What is really needed is a randomised controlled trial to address the problem definitively but you would have to do a very large study which would be very expensive and very challenging,” said Dr. Bernard Prendergast, author of the study and a cardiologist at Oxford University Hospitals NHS Trust, according to the BBC.
Rates of infective endocarditis were already on the rise before NICE made its recommendations about antibiotic use, but researchers say that there was a more significant increase after the guidelines went into effect.
After seeing the results of this recent study, NICE is reviewing its guidelines. In the meantime, both researchers and NICE officials recommend that health care professionals continue their current practices until further research is completed.