Infective Endocarditis Hospitalizations and Antibiotic Prophylaxis Rates Before and After the 2007 American Heart Association Guideline Revision

• DOI: 10.1161/circulationaha.118.037657
• Publication Date: 2019-04-26T09:00:40Z
• Authors: Pallav Garg; Dennis T. Ko; Krista M. Bray Je...; Lihua Li; Salimah Z. Shariff
• Keywords: Guideline; Infective Endocarditis; Rate ratio

Background: In 2007, the American Heart Association recommended antibiotic prophylaxis for prevention of infective endocarditis (IE) only highest-risk patients. Whether this change affected use and incidence IE is unclear. Methods: IE-related hospitalizations were identified from 2002 to 2014 among all adults those at high moderate risk IE, stratified by age. Prescriptions obtained Ontario Drug Benefit database ≥65 years Outcomes prescription rates hospitalization. Trends in patient pathogen characteristics analyzed. Time series analyses performed with segmented regression change-point analyses. Results: decreased substantially moderate-risk cohort after guideline revision (mean quarterly prescriptions, 30 680 versus 17 954 [level change, −6,481; P =0.0004] per 1 million population) a minimal, yet significant, decrease followed slow increase high-risk group. There 7551 6884 ≥18 Among age, mean rate increased 872 1385 229 283 population quarter high- groups, respectively. Change-point indicated that occurred second half 2010 3 revision. Staphylococcus aureus streptococcal species accounted 30.3% 26.4% infections over time. Conclusions: Antibiotic significantly group minimal 2007. However, both patients Our study provides support cessation population.