Published: 19 November 2014

Scientists identify a rise in life-threatening heart infection

Simon Jones, Professor of Epidemiology and Head of Integrated Care Research, is part of a team of leading scientists who have identified a significant rise in the number of people diagnosed with a serious heart infection alongside a large fall in the prescribing of antibiotic prophylaxis to dental patients.

The pioneering research was led by the University of Sheffield, with data science and statistical analysis conducted at the University of Surrey.

The study is the largest and most comprehensive to be conducted with regards to the National Institute for Health and Care Excellence (NICE) guidelines that recommended dentists should no longer give antibiotics before invasive treatments to people considered at risk of the life threatening heart infection, Infective Endocarditis (IE). In 40 per cent of cases, this infection is caused by bacteria from the mouth.

The team of international researchers, which also included experts from John Radcliffe Hospital in Oxford, Taunton and Somerset NHS Trust and Mayo Clinic College and Carolinas Medical Centres in the United States of America, discovered that since the NICE guidelines were introduced in March 2008 there has been an increase in cases of Infective Endocarditis above the expected trend. By March 2013, this accounted for an extra 35 cases per month.  

They also identified that the prescribing of antibiotic prophylaxis fell by 89 per cent from 10,900 prescriptions a month before the 2008 guidelines, to 1,235 a month by March 2008.

In light of the study, NICE announced on 20 November 2014 that it would immediately review its guidance on the use of antibiotics to prevent Infective Endocarditis. Read more.

Professor Jones said: “I was delighted to be part of the team working on this project and proud that a consortium of world leading research universities and hospitals came to Surrey to do the data science and statistical analysis.”

The research, published in The Lancet, was funded by charity Heart Research UK, healthcare provider Simplyhealth and the National Institute for Dental and Craniofacial Research (NIDCR).

Martin Thornhill, Professor of Translational Research in Dentistry at the University of Sheffield, said, “Infective Endocarditis is a rare but serious infection of the heart lining. We hope that our data will provide the information that guideline committees need to re-evaluate the benefits, or not, of giving antibiotic prophylaxis.

Stressing that healthcare professionals and patients should wait for the guideline committees to evaluate the evidence and give their advice before changing their current practice, he added, “In the meantime, healthcare professionals and patients should focus on maintaining high standards of oral hygiene. This will reduce the number of bacteria in the mouth which have the potential to cause Infective Endocarditis and reduce the need for invasive dental procedures to be performed.”

Learn more about the School of Health Sciences and the Department of Health Care Management and Policy.

Read a summary of the paper on the NHS Choices website.

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