Antibiotic prophylaxis of subacute bacterial endocarditis for adult patients by dentists in Dade County, Florida.

Abstract

To determine compliance with 1977 American Heart Association (AHA) recommendations for antibiotic prophylaxis (AbP) of subacute bacterial endocarditis (SBE), we mailed a questionnaire to 1019 licensed dentists from Dade County, Florida. Of the 614 practicing dentists who responded, 97.7% believe that AbP prevents SBE and 94.2% always obtain a cardiac history from new patients. AbP is given to patients with known rheumatic or other valvular heart disease by 98.9% of responders and to patients with known prosthetic heart valves by 81.5%. The majority of dentists prescribe the antibiotics recommended by the AHA, but the dosage, route, frequency and duration of therapy are usually not according to AHA guidelines. AbP completely consistent with these guidelines is prescribed by 15.4% of dentists for patients with heart disease and by only 6.7% of dentists for patients with prosthetic heart valves. The AHA recommends parenteral AbP for most patients with prosthetic heart valves, but approximately 80% of dentists use only oral agents for these patients. We conclude that most dental patients predisposed to SBE receive AbP, but not in accordance with AHA guidelines. The widest deviation occurs among patients with prosthetic heart valves.