Insufficient awareness of endocarditis prophylaxis in patients at risk

To determine whether patients at risk for development of infective endocarditis (IE) have adequate knowledge of IE and the need for endocarditis prophylaxis (EP), and to test the impact of reeducation on subsequent knowledge.

We assessed awareness of IE and EP in 139 patients at risk. To assess their knowledge of IE and EP, patients were asked to complete a questionnaire. 59 patients underwent education concerning IE and EP.

On the basis of 123 analysed questionnaires, 87 patients were considered high risk and 36 moderate/low risk. Overall, 59% displayed inappropriate knowledge of IE and EP, 15% did not remember receiving IE education, nor had they been given an EP card. The term "endocarditis" was correctly defined by 45%. 63% were aware of the precautions necessary for IE and 55% remembered the need for antibiotic prophylaxis prior to invasive dental procedures. More than two thirds of the patients with prior education and an EP card could not recall having their knowledge of IE and EP "brushed up" by their primary care physicians. Only 21% had not informed their dentist of their risk for IE.

Many patients at risk for IE have an inadequate knowledge of their heart disease, IE, and EP. Most of them are unaware of the need for good dental hygiene. Educational efforts should be intensified and regularly upgraded in adults with valvular disease. Communication between patient, physician and dentist needs to be improved in order to address these issues.