Antibiotic prophylaxis for bacterial endocarditis--a study of knowledge and application of guidelines among dentists and cardiologists

Abstract

Antibiotic prophylaxis and infective endocarditis is a controversial topic. The compliance with available guidelines among dentists is poor. The dental health education of patients by their cardiologists is inadequate.

Objective: The objective of this study was to investigate the knowledge and application of available guidelines on antibiotic prophylaxis to prevent infective endocarditis among general dental practitioners and cardiologists.

Design: Structured postal questionnaire

Subjects and methods: A list of 515 dentists was obtained from a register held by the Postgraduate Medical and Dental Board. A list of 85 cardiologists was obtained from a national register held by the Cardiothoracic Society of Ireland.

Results: A 31% response rate was obtained from the cardiologists and 37% from the dentists. The majority of the cardiologists (84%) were in hospital practice and 64% of dentists were in private general practice. Cardiologists showed a preference for the AHA guidelines (50%) and more dentists use the BSAC guidelines (56%). The cardiologists were very familiar with the cardiac conditions that pose a risk for dental patients but weak at educating their patients on the importance of good dental health. The dentists were good at identifying procedures that could place their patients at risk but less informed about which cardiac conditions warranted prophylaxis. Decision-making among the dentists with regard to choice of prophylaxis and appropriate treatment intervals was poor.

Conclusions: The knowledge of and compliance with the available guidelines is poor. Dental health education of at-risk patients by their cardiologists and dentists is inadequate. Further regular education of patients, dentists and medical practitioners is required.