Recommendations for prevention of bacterial endocarditis: compliance by dental general practitioners

Telephone interviews were conducted with a national sample of general practice dentists (n = 460). Clinical vignettes were used to test clinicians' knowledge of, and compliance with, the 1984 American Heart Association (AHA) recommendations for prevention of bacterial endocarditis. Analyses of the data document a relatively low level of knowledge of correct indications and regimens for antibiotic prophylaxis to prevent endocarditis. Respondents were unsure, and often incorrect, about the relationship between a variety of cardiac conditions and potential risk for endocarditis. Compliance with the guidelines for proper dosage and timing of antibiotics was also problematic. Those clinicians who had a better understanding of patient risk factors and the principles underlying the AHA recommendations were more likely to follow them, as were practitioners who kept a copy of the recommendations in the office. The findings are significant in view of previous suggestions that use of inappropriate antibiotic regimens may predispose to adverse outcomes.