BMJ  2008;336:771 (5 April), doi:10.1136/bmj.39512.666412.AD

Practice

Commentary: Controversies in NICE guidance on infective endocarditis

¹ St Mary’s Hospital, Newport, Isle of Wight PO30 5TG

doi: 10.1136/bmj.39510.423148.AD

The first 150 words of the full text of this article appear below.

Infective endocarditis has always fascinated clinicians, but until 2006 it had rarely caused fisticuffs. In that year, the British Society for Antimicrobial Chemotherapy produced guidelines on the prevention of endocarditis,¹ which incensed the British Cardiac Society, apparently causing "dismay among cardiologists and confusion among patients and dentists."² The major change was the recommendation to restrict antibiotic prophylaxis to patients judged to be at highest risk. The British Cardiac Society countered by arranging for the National Institute for Health and Clinical Excellence (NICE) to review matters. As a result, NICE has published its own guidelines. Ironically, the draft version received scathing criticism via the British Cardiac Society’s website (www.bcs.com/pages/news_full.asp?NewsID=18369177), and the definitive document seems destined to receive similar flak.

NICE no longer advocates antibiotic prophylaxis for the majority of patients in whom it would previously have been recommended, including those having dental, obstetric, gastrointestinal, and respiratory procedures. This is . . . [Full text of this article]

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