[Do dentists enforce correctly the recommendations for prophylaxis of bacterial endocarditis?].

Recommendations for the prophylaxis of infective endocarditis have been published by working groups in several countries. We performed an enquiry amongst 276 dentists in Geneva to evaluate how the Swiss recommendations were applied. Of the 183 dentists who answered, the majority knew that extraction (85%) or scaling (76%) required prophylaxis. They correctly prescribed antibiotics to patients with valve prostheses (84%), to those with rheumatic heart disease (80%), a previous history of endocarditis (73%) or congenital heart disease (49%). Not conforming to the recommendations, many dentists considered that coronary bypass surgery (40%), mitral valve prolapse without mitral regurgitation (30%) or previous myocardial infarction (22%) also required antibiotic prophylaxis. Only 34% of dentists used the recommended 3 g of amoxicillina, the others preferring a lower dose of another antibiotic. About one third started prophylaxis 1 to 3 days too early and less than 20% used the suggested single dose of antibiotics. These results showed that dentists caring for cardiac patients should be better informed of the risks of endocarditis and its prevention. We make a few suggestions to improve antibiotic prophylaxis.