Background Infective Endocarditis (IE) occurs in groups of people who are deemed high risk. Previously high-risk individuals undergoing invasive procedures were recommended prophylactic antibiotics. In 2008 NICE issued new guidance to avoid prophylactic antibiotics use.

Aim We aimed to evaluate the incidence of confirmed Infective Endocarditis in two sites across the North West region prior to and after the implementation of the 2008 guidance, including causative infective organisms, Echo findings, subsequent morbidity and mortality.

Methods OPCS-4 (Office of Population, Censuses and Surveys classification-4th Edition) system and the standard code allocated were retrospectively analysed for all admissions related to Infective Endocarditis for the years 2007–2008 and then again for the years 2012–2015.

Results The incidence of IE dramatically increased for the years after the guidance came in to effect compared to prior to the guidance. Initial data from one sites showed an increase in total numbers of cases year on year. All except 3 patients had positive blood cultures. Our data also shows that mortality remains high due to IE (2012%–18% of patients died as a direct result of IE, 2013%–38%, 2014%–11%, 2015%–21%).

Conclusions Incidence of IE has increased subsequently to the universal change in NICE guidance. Mortality associated with IE being still high. Although this is a small initial study from one centre, data from our second site is being collated to add support to our findings.