General physicians' knowledge of dental operation prophylaxis for infective endocarditis

Objectives: To evaluate the knowledge of young primary health care physicians in relation to the 1997 AHA guidelines for the prevention of bacterial endocarditis in relation to dental treatment in patients at risk. Study design: Forty-three physicians, with a median time of 2 years from medical school graduation, filled out a questionnaire that presented 8 medical conditions and 10 dental operations. The participants were asked whether or not antibiotic prophylaxis for infective endocarditis is required for each condition or operation. Later, the participants were asked to prescribe a regimen of prophylaxis for a non-allergic patient. Results: The overall correct answer rates for the 8 medical conditions and 10 dental operations were 78% and 75%, respectively. The most conspicuous lack of knowledge was with regard to hypertrophic cardiomyopathy and dental scaling. Eighty-one percent of the physicians prescribed the correct preoperative antibiotic dose, but a third of the participants prescribed an unnecessary post-operative dose. Conclusions: Although the present results are better than previous reports, there is still a need to foster the implementation of the guidelines among health care workers. Undergraduate and post-graduate education programs are needed in order to enhance the knowledge and eliminate the overuse and under-use of antibiotics, with the accompanying potential risks.