Current Status of Prophylaxis for Endocarditis.
10.4070/kcj.2005.35.4.328
- Author:
Hyun Kyun KI
1
;
Sun Hee KIM
;
Kyung Mok SOHN
;
Yu Mi WI
;
Ji Young RHEE
;
Chi Sook MOON
;
Won Sup OH
;
Kyong Ran PECK
;
Eun Suk JEON
;
Nam Yong LEE
;
Jun Seop YEOM
;
Choon Kwan KIM
;
Jun Sung SON
;
Yeon Suk KIM
;
Suk In JUNG
;
Hyun Ha JANG
;
Shin Woo KIM
;
Hyuck LEE
;
Jae Hoon SONG
Author Information
1. Division of Infectious Diseases, Department of Medicine, School of Medicine, Konkuk University, Seoul, Korea.
- Publication Type:Original Article ; Multicenter Study
- Keywords:
Endocarditis;
Antibiotic prophylaxis
- MeSH:
American Heart Association;
Amoxicillin;
Antibiotic Prophylaxis;
Compliance;
Dental Records;
Education;
Endocarditis*;
Heart Diseases;
Heart Valves;
Hospitals, University;
Humans;
Korea;
Retrospective Studies
- From:Korean Circulation Journal
2005;35(4):328-334
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Antibiotic prophylaxis of infective endocarditis is required before high-risk procedures in patient with high-risk heart diseases. Although guidelines for the prevention of infective endocarditis were proposed by the American Heart Association in 1997, compliance to these recommendations has not been evaluated in Korea. SUBJECTS AND METHODS: This was a retrospective, multicentered study in 8 Korean university hospitals. Patients with high-risk heart diseases, having undergone invasive dental procedures between Jan. 1, 2000 and Dec. 31, 2003, were enrolled. The medical and dental records of the patients were reviewed to evaluate whether the prophylaxis had been appropriate. RESULTS: Of the initial 4,912 patients, 184 that had been treated with invasive dental procedures (255 total episodes, mean 1.4/patient) were evaluated. The most common high-risk heart disease was a prosthetic heart valve (233 procedures), followed by a previous history of infective endocarditis (22 procedures), cyanotic heart diseases (5 procedures) and systemic pulmonic venous shunts (2 procedures). Antibiotic prophylaxis was performed in 231 procedures (90.8%). Amoxicillin was the most common antibiotic used for prophylaxis (88.6%); however, the adequate dosage (2 gm) was administered in only 56% of these cases. Therefore, the appropriate prophylaxis, according to the AHA recommendations, was performed in only 14.1% (36 procedures). The mean duration of prophylaxis and number of antibiotic doses were 2.40 days (2.40+/-2.44) and 7.97 doses (7.97+/-7.18), respectively. A previous history of infective endocarditis (p=0.03) and dental extraction (p<0.01) resulted in a longer duration of prophylaxis. CONCLUSION: Only 14.1% of the high risk group procedures were given appropriate antibiotic prophylaxis according to the AHA recommendations. These data suggest that protocol-based education of both doctors and patients is required for appropriate antimicrobial therapy during high-risk procedures for the prevention of infective endocarditis in patients with high-risk heart disease.
