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Request Reference: 8258 Request Date: 23 Jan 2019
Request: Dear Sir/Madam, We would like to request the same monthly prescribing data that was provided in previous requests (3664/4355) to another party (see below), extending the period to cover April 1997-Dec 2018 (or as much data as is available). We are conducting a similar study into the association between infective endocarditis and change in antibiotic prophylaxis guidelines as the original requestors. Thank you very much. Request Reference: 4355 Request Date: 02 Apr 2014 Request: Please provide an update of the data provided under request 503857 [3664]. The details of this request are provided below. Background: It used to be standard practice for all patients with certain cardiac risk factors to be given antibiotic cover (ABC) prior to invasive dental procedures to reduce the risk they would develop infective endocarditis (IE). Over several years the benefit of ABC has been questioned and in March 2008 NICE produced new guidelines advising that ABC should be stopped for all dental procedures. After March 2008 there should, therefore, have been a large reduction in ABC prescribing by dentists, doctors and other health care professionals. We are studying this Objective: We want to study: (1) If the new NICE guidelines altered (reduced) ABC prescribing. (2) If this correlates with an increase in the incidence of IE. It is important we identify as quickly as possible if this change in policy results in a significant increase in the incidence of IE. Furthermore, other countries are waiting to see the outcome of this change to ABC prescribing in the UK before deciding whether to do the same. Information Required: ABC is prescribed as a single 3 gram dose of Amoxicillin 1 hour before the dental procedure. Listed in BNF section 5.1.1.3 as Amoxicillin 3 gram sachet sugar free, or Amoxil 3 gram sachet sugar free. Patients allergic to penicillin are given a single 600mg dose of Clindamycin. As a 600mg tablet is not available, this is normally dispensed as 4 x 150mg tablets. Clindamycin 150mg is listed in BNF section 5.1.6.0 as Clindamycin 150mg or Dalacin 150mg. Although Clindamycin is prescribed for other purposes (usually at 150-300mg 6 hourly for several days), it is only prescribed as a single 600mg dose for ABC purposes. If it is possible to identify prescriptions for a single dose of 600mg it would be very important for us to have this data. We do not require data for other Clindamycin regimes however. Previous FOI requests have provided us with the monthly prescribing data for a single 3g oral dose of Amoxicillin/Amoxil and a single 600mg oral dose of Clindamycin for the period between 1st January 2004 and 1st May 2013. We now request (a) the data from Jan 2013 until January 2014 and (b) the data from January 200 until January 2004. We need this data to match the incidence dat we now have for infective endocarditis over the period Jan 200 through January 2014. You have previously given us this data split to show who issued the prescriptions: Dentist, GP, hospital or nurse practitioner. We would be grateful if you could provide the data now requested split in the same way (if possible). If it is possible to provide the information, we would also request details of the cost of prescribing a single dose 3g dose of Amoxicillin and a single 600mg dose of Clindomycin (NHS drug cost, prescribing, dispensing costs etc). I have previously discussed this study with Helen Kendall (Chief Pharmacist at the PPD) and with Margaret Dockey (Ph

Status: Complete
Response Date: 18 Mar 2019
Response: Please see attached response

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