Sir, I would like to draw the readers' attention to a very interesting article in the May issue of the British Medical Journal.1 The study highlights a three-quarter drop in antibiotic prophylactic prescriptions, while showing no statistical difference in the incidence of infective endocarditis. I would hope this article provides some evidence for the difficult consultations we have all had with a small cohort of patients who are still insistent on having the prophylaxis.