[Survey on the practice of antibiotic prophylaxis of infective endocarditis by dentists]

The authors undertook an enquiry among 287 dentists to assess their practice of prophylactic antibiotic therapy against infectious endocarditis. Of the 227 dentists who replied, most (90%) knew that a dental extraction required prophylactic antibiotic therapy. They correctly prescribed antibiotics to prosthetic valve patients (84%) and to those with post-rheumatic cardiac disease (87%). Many dentists considered that coronary bypass (66%), mitral valve prolapse without mitral regurgitation (65%) or chronic myocardial infarction (68%) also required antibiotic prophylaxis, contrary to published recommendations. Only 21% of dentists used the recommended 3 gram dose of amoxicillin; the others prescribed a lower dose or another antibiotic. Approximately half the dentists started treatment 1 to 3 days too soon and less than 5% used the recommended single dose of antibiotic. These results show that dentists do not adhere strictly to the rules of prophylaxis on infectious endocarditis defined by different working groups. The authors make several suggestions to improve the prevention of infectious endocarditis and to remedy the problems shown up by this study.