Time for a Definitive Trial
In an accompanying commentary in the Lancet[3], Drs Xavier Duval and Bruno Hoen (Association pour l'Etude et la Prévention de l'Endocardite Infectieuse, Paris, France) commend the study authors for "not jumping to conclusions about the causality of the link between cessation of antibiotic prophylaxis and subsequent increased incidence of infective endocarditis."
However, the findings could cause confusion. A randomized controlled trial is long overdue, they add.
"More than 20 years [after a call for a definitive study], no such study has been done. We strongly suggest that experts stop elaborating guidelines for infective endocarditis prophylaxis and urgently join forces to mount an international collaboration to do the appropriate clinical trials that are needed to answer this important question," they conclude.
The authors and editorialists have reported they have no relevant financial relationships.