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Implementation Advice for National Institute for Health and Care Excellence (NICE) Clinical Guideline 64 Prophylaxis Against Infective Endocarditis

Published August 2018

This publication has been endorsed by NICE which signifies that the advice supports the implementation of recommendations in the NICE guideline Prophylaxis against infective endocarditis.


Video introduction

Antibiotic ProphylaxisA short video of the implementation advice which outlines the background and key messages is available.

Supporting Tools

Supporting tools to assist the dental team are available for download and printing. A patient information leaflet is also provided. Accessible versions are available.

Advice and Tools for Cardiology and Cardiac Surgical Teams

Advice for Cardiology and Cardiac Surgical teams has been developed in collaboration with the British Cardiovascular Society.

Please note that these publications are only available as downloadable online resources and are not available from SDCEP as printed copies.

About this advice

NICE Clinical Guideline 64 (CG64), first published in 2008, updated in 2015 and amended in 2016, includes recommendations on preventing infective endocarditis in people who are at increased risk of developing this condition. Antibiotic Prophylaxis Against Infective Endocarditis was developed to address concerns among dental and cardiology professionals over interpretation and consistency of application of CG64 following the 2016 amendment. It aims to provide clear and practical advice for dental teams on how to implement CG64 and provide appropriate care for patients at increased risk of infective endocarditis.

Advice for cardiology and cardiac surgical teams is also included. An information leaflet for patients is provided to help practitioners explain the NICE recommendation, support discussions with patients and parents or carers and provide reassurance about their care.

The advice in this document is applicable to dentists working in a primary care setting and to those working in secondary care and is also of relevance to patients and the medical professionals involved in their care.

This implementation advice has been endorsed by the Dental Faculties of the Royal College of Surgeons of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Surgeons of England, the Faculty of General Dental Practice (UK) and the British Cardiovascular Society. While primarily developed for users in Scotland, use of this advice is also supported by the Department of Health Northern Ireland, the Welsh Government and Public Health England.

Development of this implementation advice

This SDCEP advice is a departure from conventional clinical guidance in that it supports the implementation of evidence-based recommendations from another organisation rather than providing independently developed evidence-based clinical recommendations. The advice was developed following a rapid process that draws on elements of SDCEP’s accredited guidance development methodology. A short-life working group including experienced healthcare professionals from dentistry, cardiology and pharmacy, members of the NICE CG64 development committee and patient representatives, was convened to develop the implementation advice based on a consensus of expert opinion after consideration of the available information and evidence. The advice was subject to UK-wide open consultation prior to finalising for publication.

Further information about the development of this advice is available on request. Please contact the SDCEP office (

Short-life working group

A working group comprising individuals from a range of relevant branches of the dental profession, other healthcare disciplines and patient representatives was convened to develop this implementation advice.

SDCEP acknowledges the important contribution of all those who commented during the consultation stage.

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