Curbing Antibiotic Prophylaxis Doesn't Up Endocarditis Risk
(HealthDay News) – The incidence of viridans group streptococci infective endocarditis (VGS-IE) has not increased since the publication of the 2007 American Heart Association (AHA) guidelines restricting prophylactic antibiotics in dental patients.
To investigate the incidence of VGS-IE since publication of the 2007 AHA guidelines, Daniel C. DeSimone, MD, from the Mayo Clinic in Rochester, MN, and colleagues reviewed all definite or possible cases of VGS-IE (1999–2010) using data from the Rochester Epidemiology Project of Olmsted County, MN. In addition, they examined the Nationwide Inpatient Sample hospital discharge database for VGS-IE cases (1999–2009).
During the 12-year study period, the researchers identified 22 cases of VGS-IE in Olmsted County. Incidence rates (per 100,000 person-years) were 3.19 for 1999–2002, 2.48 for 2003–2006, and 0.77 for 2007–2010 (P=0.061 from Poisson regression). The national number of hospital discharges with a VGS-IE diagnosis ranged from 15,318–15,938 in 1999–2002; from 16,214–17,433 for 2003–2006; and from 14,728–15,479 in 2007–2009.
"Despite marked changes in IE prevention guidelines that were published by the AHA in 2007 that restricted antibiotic prophylaxis to four patient groups with a high risk of complications from IE, the findings of our population-based investigation from Olmsted County suggest that the incidence of VGS-IE after publication of these guidelines did not increase," the authors conclude.
One author disclosed financial ties to UpToDate Inc.; a second author disclosed ties to TyRx Inc.