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Background: In 2007, American Heart Association (AHA) produced new guidelines recommending antibiotic (AB) prophylaxis for infective endocarditis (IE) for only the highest-risk patients. Our aim was to evaluate potential impact of these revised guidelines on the AB prophylaxis prescription rate and the incidence of IE in Ontario, Canada.
Methods: Data were obtained from health administrative databases (2002-2014). Prescriptions for antibiotic prophylaxis were obtained from the Ontario Drug Benefit database (> 65 age group). Cases of IE-related hospitalizations were identified from Canadian Institute for Health Information Discharge Abstract Database.
Results: Quarterly AB prophylaxis prescriptions increased gradually from 8040 to 9880 per million population from 2002 to April 2007, followed by a steep and sustained decline to 6450 per million population, after guideline change in April 2007 (graph, top panel). There were a total of 7639 IE-related hospitalizations from 2002 to 2014. IE rates remained stable from 2002 through 2007. There was a steady increase in rates of IE from 2008 to 2014 (average annual increase of 6 and 14 per million population in the overall population and > 65 age group, respectively; graph, bottom panel).
Conclusions: AB prophylaxis decreased dramatically following the publication of the 2007 AHA guidelines. While IE-related hospitalizations have increased since 2008, further investigation is required to determine if this increase is related to change in AB prophylaxis.
Moderated Poster Contributions
Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 1:00 p.m.-1:10 p.m.
Session Title: Infectious Endocarditis: Comprehensive Perspectives
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1313M-07
- 2017 American College of Cardiology Foundation