Shah ASV, McAllister DA, Gallacher P, et al. - Temporal changes in the incidence, microbiology and outcomes of infective endocarditis were investigated and the impact of changes in national antibiotic prophylaxis guidelines on incident infective endocarditis was determined. Researchers identified 7,638 patients, who were hospitalized with infective endocarditis from 1990 until 2014, using a Scotland-wide, individual-level linkage approach, and linked them to national microbiology, prescribing and morbidity and mortality datasets. Analysis revealed an increase in the estimated crude hospitalization rate from 5.3/100,000 to 8.6/100,000 between 1990 and 1995 but this rate remained stable thereafter. Despite the 2008 change in antibiotic prophylaxis guidelines, the crude incidence of infective endocarditis has remained stable. In the elderly, however, the incidence rate has doubled. Less than half of patients had positive blood cultures, with Staphylococcus aureus and enterococcus bacteremia linked with worse outcomes.