Brooks R G, Notario G, McCabe R E
Department of Internal Medicine, Orlando Regional Medical Center, Florida 32806.
Am J Med. 1988 Mar;84(3 Pt 2):617-21. doi: 10.1016/0002-9343(88)90145-3.
The American Heart Association (AHA) has published guidelines for use of prophylactic antibiotics to prevent bacterial endocarditis, but few data are available about physician compliance with these guidelines. A retrospective review was conducted of the use of prophylactic antibiotics in patients with prosthetic heart valves who were undergoing diagnostic or operative procedures or heart catheterization at three hospitals. Compliance with AHA recommendations was only 30 percent (14 of 46) for procedures considered high risk for patients with prosthetic heart valves. Six (23 percent) of 26 patients who underwent right or left heart catheterization received prophylactic antibiotics (not recommended by AHA). Antibiotics were given to 42 (74 percent) of 57 patients who underwent surgical procedures considered at low risk of bacteremia, but only 33 (58 percent) received antibiotics that cover organisms commonly present at the site of the procedure. The results indicate that clinicians frequently do not administer prophylactic antibiotics in patients with prosthetic heart valves who are undergoing invasive procedures or do not follow published AHA guidelines when antibiotics are administered.
美国心脏协会（AHA）已发布关于使用预防性抗生素预防细菌性心内膜炎的指南，但关于医生对这些指南的依从性的数据却很少。对在三家医院接受诊断或手术操作或心脏导管插入术的人工心脏瓣膜患者预防性抗生素的使用情况进行了回顾性研究。对于人工心脏瓣膜患者被认为高风险的操作，对AHA建议的依从性仅为30%（46例中的14例）。接受右心或左心导管插入术的26例患者中有6例（23%）接受了预防性抗生素（AHA不推荐）。在57例接受被认为菌血症低风险手术操作的患者中，42例（74%）接受了抗生素治疗，但只有33例（58%）接受了覆盖手术部位常见病原体的抗生素。结果表明，临床医生在为接受侵入性操作的人工心脏瓣膜患者使用预防性抗生素时，往往不遵循已发布的AHA指南，或者根本不使用预防性抗生素。
