6419/37 Aim21(3)

Introduction Recent surveys have shown acupuncture treatment to be safe and the risk of major complications extremely low. Subacute bacterial endocarditis is a known serious complication that can follow acupuncture treatment but the reporting of such events in the literature is rare. Of these isolated reports, most have been associated with the use of semi-permanent needles, which have been left in the ear. The reports of endocarditis associated with acupuncture have led some authors not only to suggest that those patients, in particular those with prosthetic valves, should not be given this type of treatment but also that, if given, prophylactic antibiotics should be prescribed at the same time. The rationale being that the presence of valvular heart disease is the most common predisposing factor for the development of endocarditis, and that an invasive procedure, such as acupuncture, is another factor associated with the development of this condition. However, one study has shown there to be no association of endocarditis with a variety of invasive procedures up to one year prior to the diagnosis of endocarditis. Therefore is acupuncture, an invasive procedure, safe in patients with valvular heart disease? This Anthony Stellon general practitioner medical acupuncturist Dover, UK