Physician compliance with American Heart Association guidelines for prevention of bacterial endocarditis in dental procedures

Aim: To evaluate physicians' compliance level with the American Heart Association (AHA) 2007 guidelines concerning the management of dental patients at risk for bacterial endocarditis. Materials and methods: This study included 103 patients with cardiac problems. The mean age was 41.02 +/- 15.22 years. According to consultations with physicians, the selection of the antibiotic, the timing, and the dosage were recorded on patients' forms prior to dental procedures by the researchers of the Department of Oral and Maxillofacial Surgery and Department of Oral Diagnosis and Radiology. Physicians' compliance level with the AHA 2007 recommendations was evaluated. Results: Antibiotic prophylaxis was prescribed for 75 (72.8%) of 103 patients with cardiac problems although it was not indicated. On the other hand, antibiotic prophylaxis was recommended with correct indication for 22 patients (21.3%). Two (9.1%) of these 22 patients were prescribed appropriate antibiotics, with correct dosage and timing by the physicians according to the AHA 2007 guidelines. Amoxicillin (20.0%) and combinations of the antibiotics (20.0%) were the first choices for prophylaxis. No antibiotic regimen was prescribed for 6 patients (5.9%), who did not require antibiotic prophylaxis according to the AHA 2007 guidelines. Conclusion: Clinicians are not always aware of the current clinical guidelines regarding antibiotic prophylaxis and must be aware of the contemporary guidelines and avoid prescribing excessive antibiotics to prevent emergence of resistant organisms.