Bennis A, Soulami S, Khadir R, Chraibi N
Centre de cardiologie. CHU lbn-Rochd Casablanca Maroc.
Arch Mal Coeur Vaiss. 1996 Jun;89(6):713-8.
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.
作者对287名牙医进行了一项调查,以评估他们针对感染性心内膜炎进行预防性抗生素治疗的做法。在227名回复的牙医中,大多数(90%)知道拔牙需要预防性抗生素治疗。他们给人工瓣膜患者(84%)和风湿性心脏病患者(87%)正确开了抗生素。许多牙医认为冠状动脉搭桥手术(66%)、无二尖瓣反流的二尖瓣脱垂(65%)或慢性心肌梗死(68%)也需要抗生素预防,这与已发表的建议相反。只有21%的牙医使用推荐的3克剂量阿莫西林;其他牙医开的剂量较低或使用了其他抗生素。大约一半的牙医过早1至3天开始治疗,不到5%的牙医使用推荐的单剂量抗生素。这些结果表明,牙医并未严格遵守不同工作组定义的感染性心内膜炎预防规则。作者提出了一些建议,以改善感染性心内膜炎的预防,并解决本研究中出现的问题。