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<DIV><FONT size=2 face=Arial>OK.- </FONT></DIV>
<DIV><FONT size=2 face=Arial>Veremos si se encuentra resistencia al empleo de
esta guía del N.I.C.E en nuestro medio.- </FONT></DIV>
<DIV><FONT size=2 face=Arial>Un abrazo:</FONT></DIV>
<DIV><FONT size=2 face=Arial></FONT> </DIV>
<DIV><FONT size=2 face=Arial>EDGARDO </FONT></DIV>
<BLOCKQUOTE
style="BORDER-LEFT: #000000 2px solid; PADDING-LEFT: 5px; PADDING-RIGHT: 0px; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px">
<DIV style="FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV
style="FONT: 10pt arial; BACKGROUND: #e4e4e4; font-color: black"><B>From:</B>
<A title=edgardoschapachnik@grupoakros.com.ar
href="mailto:edgardoschapachnik@grupoakros.com.ar">Dr. Edgardo Schapachnik</A>
</DIV>
<DIV style="FONT: 10pt arial"><B>To:</B> <A
title=cardio_argerich@grupoakros.com.ar
href="mailto:cardio_argerich@grupoakros.com.ar">Lista de uso exclusivo para
miembros y ex miembros del Servicio de Cardiología del Hospital Argerich de
Buenos Aires. </A></DIV>
<DIV style="FONT: 10pt arial"><B>Sent:</B> Friday, May 06, 2011 8:37 AM</DIV>
<DIV style="FONT: 10pt arial"><B>Subject:</B> [Cardio_Argerich] Profilaxis
antibiótica de la EI</DIV>
<DIV><BR></DIV>Queridos amigos:
<DIV>En mi nuevo rol de asesor en ETS (Evaluaci�n de nuevas Tecnolog�as
Sanitarias) interesante bibliograf�a no habitual llega a mis manos.</DIV>
<DIV>Este art�culo, que remite a una lectura del BJM es de sumo inter�s.</DIV>
<DIV>Para qui�nes no lo sepan, les comento que NICE es la principal agencia
asesora en ETS del UK.</DIV>
<DIV>Lo que est� en negrita con mayor tama�o de letra, es m�o</DIV>
<DIV><BR></DIV>
<DIV>Un abrazo</DIV>
<DIV><BR></DIV>
<DIV>Edgardo</DIV>
<DIV><BR></DIV>
<DIV><A
href="http://www.nice.org.uk/newsroom/news/AntibioticPrescribingCutByThreeQuarters.jsp">http://www.nice.org.uk/newsroom/news/AntibioticPrescribingCutByThreeQuarters.jsp</A></DIV>
<DIV><BR></DIV>
<DIV>
<P
style="LINE-HEIGHT: 33px; BACKGROUND-COLOR: #cbc5c2; MARGIN: 0px 0px 10px"><FONT
style="FONT: 30px Verdana; COLOR: #082031" color=#082031 size=7
face=Verdana>Antibiotic prescribing cut by three-quarters following NICE
advice</FONT></P><BR><IMG
src="cid:1F0CA8CDA0254CD6B222432F3F2BC6F2@nenee927f95fa3">
<DIV
style="MARGIN: 0px; MIN-HEIGHT: 15px; FONT: 12px Verdana; COLOR: rgb(74,66,62)"><BR></DIV>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>NICE guidance has helped to cut down on unnecessary antibiotic
prescribing for the prevention of infective endocarditis, latest research
suggests.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>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.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>Despite advances in diagnosis and treatment, infective
endocarditis remains a life-threatening disease with significant mortality of
around 20 per cent.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>Antibiotics have been offered routinely for more than 50 years as
a preventative measure to people at risk of infective endocarditis.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>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.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>As a result, NICE <A
href="http://www.nice.org.uk/nicemedia/live/11938/40014/40014.pdf"><FONT
style="COLOR: #984143" color=#984143>recommended</FONT></A> 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.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>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.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>They found that in the 12 months after the introduction of the
NICE guideline, the prescribing of antibiotic prophylaxis for infective
endocarditis declined rapidly.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>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.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>The reduction in antibiotic use did not cause an increase in
cases of infective endocarditis or in the number of deaths from the
disease.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>Writing in the <A
href="http://www.bmj.com/content/342/bmj.d2392"><FONT style="COLOR: #984143"
color=#984143>British Journal of Medicine</FONT></A>, 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.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e><B><FONT
class=Apple-style-span size=4><SPAN style="FONT-SIZE: 14px"
class=Apple-style-span>They concluded that the findings �support the cessation
of antibiotic prophylaxis before dental and other invasive
procedures.�</SPAN></FONT></B></FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>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 <A
href="http://www.nice.org.uk/usingguidance/donotdorecommendations/index.jsp"><FONT
style="COLOR: #984143" color=#984143>�do not do�
database</FONT></A>.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana>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.</FONT></P>
<P style="LINE-HEIGHT: 16px; MARGIN: 0px 0px 10px"><FONT
style="FONT: 12px Verdana; COLOR: #4a423e" color=#4a423e size=3
face=Verdana><B>6 May 2011</B></FONT></P><BR>
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<DIV>
<DIV>----</DIV>
<DIV>Dr. Edgardo Schapachnik</DIV>
<DIV><A
href="mailto:edgardoschapachnik@grupoakros.com.ar">edgardoschapachnik@grupoakros.com.ar</A></DIV>
<DIV>Presidente de la Asociaci�n "Carlos Chagas"</DIV>
<DIV>Director General y Cient�fico Grupo AKROS</DIV></DIV></SPAN><SPAN></SPAN>
<DIV>-------------</DIV>
<DIV><FONT class=Apple-style-span size=1><SPAN style="FONT-SIZE: 9px"
class=Apple-style-span><B><I><FONT class=Apple-style-span color=#ff0000>Hay
hombres que luchan un d�a y son buenos.</FONT></I></B></SPAN></FONT></DIV>
<DIV><FONT class=Apple-style-span size=1><SPAN style="FONT-SIZE: 9px"
class=Apple-style-span><B><I><FONT class=Apple-style-span color=#ff0000>Hay
otros que luchan un a�o y son mejores.</FONT></I></B></SPAN></FONT></DIV>
<DIV><FONT class=Apple-style-span size=1><SPAN style="FONT-SIZE: 9px"
class=Apple-style-span><B><I><FONT class=Apple-style-span color=#ff0000>Est�n
los que luchan toda la vida: esos son los
imprescindibles.</FONT></I></B></SPAN></FONT></DIV>
<DIV><FONT class=Apple-style-span size=1><SPAN style="FONT-SIZE: 9px"
class=Apple-style-span><B><I><FONT class=Apple-style-span
color=#ff0000>Bertold Brecht</FONT></I></B></SPAN></FONT></DIV><SPAN
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class=Apple-style-span><BR
class=Apple-interchange-newline></SPAN></SPAN></SPAN></SPAN></SPAN><BR
class=Apple-interchange-newline></SPAN></DIV><BR></DIV>
<P>
<HR>
<P></P>_______________________________________________<BR>Cardio_Argerich
mailing
list<BR>Cardio_Argerich@grupoakros.com.ar<BR>http://www.grupoakros.com.ar/mailman/listinfo/cardio_argerich<BR></BLOCKQUOTE></BODY></HTML>