An important change in infective endocarditis prevention guidance

Recent changes to the National Institute for Health and Care Excellence (NICE) guidelines combined with an update to the implementation advice from the Scottish Dental Clinical Effectiveness Programme (SDCEP) have resulted in significant changes to the advice given to dentists concerning the prevention of infective endocarditis (IE). In contrast to a previous NICE recommendation against the use of AP for IE prevention, dentists are now recommended to offer antibiotic prophylaxis (AP) to all individuals at high-risk of IE before extractions or oral surgery procedures, and to consider AP for high-risk individuals undergoing any other at-risk dental procedures that involve manipulation of the gingival or periapical region of the teeth.Most UK cardiologists, cardiothoracic surgeons and infectious disease specialists (alongside many National Health Service trusts, several of which incorporate dental schools and hospitals) follow the European Society for Cardiology (ESC) guidelines. Awareness of the changes made by NICE and SDCEP, and the similarities and differences between their updated recommendations and the ESC guidelines, is therefore essential.