[Cardio_Argerich] Profilaxis antibiótica de la EI

[Dr. Edgardo Schapachnik]

Queridos amigos:
En mi nuevo rol de asesor en ETS (Evaluación de nuevas Tecnologías  
Sanitarias) interesante bibliografía no habitual llega a mis manos.
Este artículo, que remite a una lectura del BJM es de sumo interés.
Para quiénes no lo sepan, les comento que NICE es la principal  
agencia asesora en ETS del UK.
Lo que está en negrita con mayor tamaño de letra, es mío

Un abrazo

Edgardo

http://www.nice.org.uk/newsroom/news/ 
AntibioticPrescribingCutByThreeQuarters.jsp

Antibiotic prescribing cut by three-quarters following NICE advice




NICE guidance has helped to cut down on unnecessary antibiotic  
prescribing for the prevention of infective endocarditis, latest  
research suggests.

Antibiotic prophylaxis prescribing fell by 78.6 per cent following  
the introduction of NICE guidelines for infective endocarditis - an  
infection of the lining of the heart that is caused mainly by  
bacteria but occasionally by other infectious agents.

Despite advances in diagnosis and treatment, infective endocarditis  
remains a life-threatening disease with significant mortality of  
around 20 per cent.

Antibiotics have been offered routinely for more than 50 years as a  
preventative measure to people at risk of infective endocarditis.

However, there is little evidence to support this practice and any  
benefits from antibiotic prophylaxis need to be weighed against the  
risks of adverse effects for the patient and of developing antibiotic  
resistance.

As a result, NICE recommended in March 2008 that antibiotic  
prophylaxis should no longer be offered routinely for all patients at  
risk of infective endocarditis undergoing dental and a wide range of  
other invasive procedures.

Researchers, led by Professor Martin Thornhill, from the University  
of Sheffield, School of Clinical Dentistry, decided to assess the  
impact of the NICE guidelines by studying national prescribing data  
in England, as well as data recorded for all inpatient hospital  
activity in the UK.

They found that in the 12 months after the introduction of the NICE  
guideline, the prescribing of antibiotic prophylaxis for infective  
endocarditis declined rapidly.

In order to compare more stable periods of prescribing for antibiotic  
prophylaxis, the 12 months before the introduction of the guideline  
was compared with the most recent 12 months of prescribing data. This  
resulted in a 78.6 per cent reduction in antibiotic prescribing  
following the launch of the NICE guidelines.

The reduction in antibiotic use did not cause an increase in cases of  
infective endocarditis or in the number of deaths from the disease.

Writing in the British Journal of Medicine, the researchers say that  
the decrease in prescribing of antibiotics in the months after the  
introduction of the guideline was large and suggests much better  
compliance than is often seen after policy changes in medicine, with  
particularly good compliance among dentists.

They concluded that the findings “support the cessation of  
antibiotic prophylaxis before dental and other invasive procedures.�

The recommendations advising against the use of antibiotic  
prophylaxis to prevent infective endocarditis can also be found on  
the NICE website as part of the “do not do� database.

The database contains recommendations on clinical practices that  
should be discontinued completely or should not be used routinely in  
the NHS, and contains recommendations that have been made since 2007,  
taken from NICE cancer service guidance, clinical guidelines,  
interventional procedures and technology appraisals guidance.

6 May 2011


----
Dr. Edgardo Schapachnik
edgardoschapachnik en grupoakros.com.ar
Presidente de la Asociación "Carlos Chagas"
Director General y Científico Grupo AKROS
-------------
Hay hombres que luchan un día y son buenos.
Hay otros que luchan un año y son mejores.
Están los que luchan toda la vida: esos son los imprescindibles.
Bertold Brecht



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