In 2008 guidance recommended no longer using antibiotics to prevent people getting infections of the heart after having surgery at their dentists. This was because there was no strong evidence showing this was necessary, and to reduce overall use of antibiotics to avoid increasing antibiotic resistance in future. However, in 2015, a group looked at all admissions to NHS hospitals that had been recorded as being for heart infections. They found that these happened more frequently than would have been expected after the guidance was changed. The problem with these kind of analyses is that it is difficult to be confident about exactly what has caused a specific code to be recorded in a patient’s records. From other studies we know that there have been changes over time in how different diagnostic codes are used, reflecting changes in the way hospitals are managed and paid. We also know that extra codes are used much more frequently now than in the past. We plan to use the extra information about germs grown from patient samples and results of blood tests available in IORD to look in more detail at heart infections in Oxfordshire, and how these may have changed over time.
See publication: ‘Caveat emptor’: the cautionary tale of endocarditis and the potential pitfalls of clinical coding data—an electronic health records study