Life-threatening bacterial endocarditis occurs on previously damaged cardiac valves. Established dental practice has been to administer antibiotics to patients who are at risk. This practice has been linked with increased antibiotic resistance, which represents one of the greatest threats to public health.
Researchers at the University of Manchester (UoM) evaluated the evidence for this practice by undertaking a high quality systematic review (initially published 2004). The review has informed multiple international guidelines. Publication of the NICE guideline led to a fall in the unnecessary prescription of antibiotics from 10,727 to 2,292 per month, an approximate annual saving of £174,580.