A change in NICE guidelines on antibiotic prophylaxis of Infective Endocarditis

The NICE guidelines on the antibiotic prophylaxis of IE have now changed allowing a more flexible approach with the addition of one word ‘routinely’: ‘antibiotic prophylaxis is not ROUTINELY recommended for patients with susceptible cardiac lesions’  (See NICE website).

 This change is discussed in the latest British Dental Journal opinion piece, published on 12th August 2016: a change in the NICE Guidelines on antibiotic prophylaxis  M.H.Thornhill et al, Br Dent J.  2016; 221:112-3

 This article discusses the reasons for this recent change. It recommends that cardiologists and dental practitioners such as Dr. Mana Nejadi should discuss the pros and cons of antibiotic prophylaxis with a patient who has a high risk cardiac lesion, such as a prosthetic valve or previous endocarditis, who is due to have an invasive dental procedure.  If prophylaxis is given, the published opinion piece recommends the adoption of the 2015 Guidelines on prophylaxis published by the European Society of Cardiology.  The article points out that the law concerning informed consent has also changed recently and there is now a  legal requirement for the patient to have the final decision about whether prophylaxis is given or not.