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Apparent Failure in Endocarditis Prophylaxis

Martin S. Greenberg, DDS
JAMA. 1984;251(24):3221-3222. doi:10.1001/jama.1984.03340480015008.
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To the Editor.—  I read the article by Durack et al,1 "Apparent Failure of Endocarditis Prophylaxis," with interest, since objective data regarding the value of the antibiotic regimen recommended by the American Heart Association and the American Dental Association are not currently available. The national registry on rheumatic fever and bacterial endocarditis described in the article is a worthwhile effort to obtain vital information. However, it appears that important data are being lost since a report is only obtained from the physician treating the patient for bacterial endocarditis. For example, the authors describe the antibiotic used and duration of prophylaxis but not the preoperative loading dose that is considered the most important aspect of the prophylactic regimen. This information would be best obtained from the dentist or surgeon who prescribed the antibiotic prior to the procedure. I suggest that follow-up questionnaires be sent these clinicians for every reported case


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