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[Correspondence] Infective endocarditis and antibiotic prophylaxis – Authors’ reply

John Chambers and Jonathan Sandoe raise concerns that our data are limited by scarcity of microbiological information. We agree, and are pursuing this further. Data from Public Health England, the most robust data available, suggest a decline in staphylococcal bacteraemia and septicaemia between 2003 and 2012 and a corresponding increase in streptococcal bacteraemias (appendix). Furthermore, US studies have identified a concerning increase in streptococcal infective endocarditis since modification of the American College of Cardiology (ACC) and American Heart Association (AHA) guidelines in 2007.