Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of advising prophylactic antibiotics for those at risk of endocarditis from basic dental examinations.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

No assessment has been made by the Department, however the National Institute for Clinical Excellence (NICE) has guidance on the use of antibiotic prophylaxis to prevent infective endocarditis in NICE Clinical Guideline CG64, which can be found at the following link:

https://www.nice.org.uk/guidance/cg64

This guideline states that antibiotic prophylaxis to prevent infective endocarditis is not currently routinely recommended for people undergoing dental procedures, but it is recommended for a small number of people who are at increased risk of infective endocarditis, such as those with certain structural heart conditions. For these individuals, clinicians should provide clear information on the risks and benefits and may consider antibiotic prophylaxis on an individual basis following an informed discussion, rather than as part of routine care. Where used, prophylaxis is typically limited to a single, targeted dose, consistent with antimicrobial stewardship principles.

From an antimicrobial resistance perspective, the Department’s position is that preventing infection in the first place, through good oral hygiene, timely access to dental care, and effective infection prevention and control, is the most sustainable way to reduce both endocarditis risk and the need for antibiotics. NICE has recently highlighted additional advice for high‑risk groups, but has confirmed that the evidence remains insufficient to change the overall recommendation against routine antibiotic prophylaxis, which can be found at the following link:

https://www.nice.org.uk/guidance/cg64/chapter/recommendations

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