Infective endocarditis cases increased after changes to prophylaxis recommendations

In 2007 the American Heart Association updated its recommendations for antibiotic prophylaxis (AP) to prevent infective endocarditis (IE). The significant change was that AP should not be offered for those at moderate risk of IE. Examination of a large health claims database revealed that by 2015, the 2007 recommendation change was associated with a 64% decrease fall in AP prescribing for those at moderate risk and a 20% decrease for people at high risk. Associated with this was a barely significant 75% (95% CI: 3% to 200%) estimated increase in IE incidence among moderate-risk individuals and a 177% increase (95% CI: 66% to 361%) among those at high risk. The decrease in antibiotic prophylaxis prescribing for people at high risk is identified as a specific concern. Read the origin research here