Hospitalizations for endocarditis have decreased among elderly patients in recent years, despite a recommendation to limit antibiotic use geared toward preventing such infections, according to the results of a new study. In 2007, the American Heart Association revised its recommendations for antibiotic use to prevent endocarditis, the most serious cardiac infection. The new recommendations suggest that preventive antibiotics should only be taken by a subgroup of high-risk patients undergoing dental procedures. The study, published online in the Journal of the American College of Cardiology, analyzed trends in endocarditis hospitalizations and outcomes in Medicare Fee-For-Service beneficiaries aged 65 and older from 1999 to 2010. The researchers calculated annual hospitalization rates and 30-day and 1-year mortality rates for patients discharged with a principal or secondary diagnosis of endocarditis. They then compared hospitalization and mortality rates before and after the American Heart Association issued its revised recommendations for endocarditis antibiotic prophylaxis in 2007. A total of 262,658 beneficiaries were hospitalized with endocarditis throughout the study period. In 1999, the adjusted annual hospitalization rate for endocarditis was 72.0 per 100,000 person-years. This rate increased to 83.5 hospitalizations per 100,000 person-years in 2005. However, the rate decreased steadily beginning in 2006, reaching 70.6 hospitalizations per 100,000 person-years in 2010. Mortality rates ranged from 14.2% to 16.5% after 30 days and from 32.6% to 36.2% after 1 year. The results did not indicate an increase in hospitalization or mortality rates for endocarditis after the 2007 recommendation to limit preventive antibiotic use. Hospitalization rates consistently declined among all demographic subgroups. However, black patients and those aged 85 and older generally had higher rates of hospitalization and mortality compared with those in other race and age...