Heart Infection Causing Fewer Hospitalizations, Researchers Say

Study found drop in endocarditis cases despite reduced use of preventive antibiotics

By Robert Preidt

Thursday, September 19, 2013

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THURSDAY, Sept. 19 (HealthDay News) -- Hospitalizations for a deadly heart infection that affects mainly older people have declined in recent years, a new study finds. This was seen even with recommendations for more limited use of antibiotics to prevent the illness, called endocarditis.
Specifically, endocarditis is inflammation of the inside living of the heart valve and chambers, according to the U.S. National Heart, Lung, and Blood Institute. The risk of endocarditis increases when people have surgery, and it's considered the most serious infection of the cardiovascular system.
There was a significant increase in rates of hospitalization for endocarditis in the 1990s, which led many doctors to prescribe antibiotics before dental procedures and certain types of surgery.
However, the American Heart Association has narrowed the recommended use of antibiotics to prevent endocarditis to only a subgroup of patients undergoing dental procedures.
In this study, Yale School of Medicine researchers looked at the annual rates of endocarditis-related hospitalizations and related outcomes among more than 262,000 Medicare patients 65 and older between 1999 and 2010.
An increase in hospitalizations for endocarditis occurred between 1999 and 2005, but there was a decline between 2006 and 2010, according to the study in the August Journal of the American College of Cardiology.
"We were surprised to see reduced rates of endocarditis hospitalizations during this time period," study first author Dr. Behnood Bikdeli, a postdoctoral associate in cardiovascular medicine, and an internal medicine resident, said in a Yale news release.
"This downward trend was consistent in all major study subgroups, but certain subgroups, including black participants, had higher hospitalization rates and worse outcomes in the study period," he added.
This racial disparity in outcomes, as well as reasons for the overall decline in hospitalizations, require further investigation, Bikdeli said.
"Clinicians should consider the risks and benefits of antibiotic use on a case-by-case basis and should share the information with their patients for appropriate decision making," he concluded.

SOURCE: Yale University, news release, Sept. 16, 2013

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