英国発の抗菌薬による感染性心内膜炎予防ガイダンスから導き出された衝撃と現在地

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  • Antibiotics prophylaxis for infective endocarditis due to oral procedure. How should you perform in your clinic today?

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  Antibiotic prophylaxis (AP) of Infective endocarditis(IE)due to oral procedures has been considered as effective for several decades. However, there has never been a randomized clinical trial to demonstrate the effectiveness of antibiotics use. Recent AHA recommendation (2007) decided that AP is recommended for only high-risk patients. On 2008, the UK National Institute for Health and Care Excellence (NICE) published new guidance recommending that AP in the UK should cease. In 2014, data suggests that there has been a significant increase in the incidence of IE since the 2008 guidance. Despite reviewing the same evidence NICE and European Society of Cardiology reached different conclusions. NICE continues for their 2008 guidance, on the other hand ESC concluded that there was evidence for the efficacy and value of AP particularly for high-risk patients. This review described recent movement of AP for IE in Europe and rest of the world.

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