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Physicians' recommendations to patients for use of antibiotic prophylaxis to prevent endocarditis.

Publication ,  Journal Article
Seto, TB; Kwiat, D; Taira, DA; Douglas, PS; Manning, WJ
Published in: JAMA
July 5, 2000

CONTEXT: The American Heart Association recommendations for infectious endocarditis (IE) prophylaxis, published in June 1997, sought to improve patient and physician compliance by simplifying the dosing regimen and clarifying endocarditis risk. Adherence to these updated recommendations in patients with echocardiographic verification of their endocarditis risk profile is unknown. OBJECTIVE: To determine the recommended and actual use of IE prophylaxis as reported by patients undergoing echocardiography. DESIGN, SETTING, AND PARTICIPANTS: All patients who underwent outpatient transthoracic echocardiography at a university-based tertiary hospital in Boston, Mass, during December 1997 were contacted 6 to 9 months later to respond to a survey, completed by 218 (80%) eligible subjects. MAIN OUTCOME MEASURE: Patients' report of their physicians' instructions on actual use of IE prophylaxis in accordance with patient risk category, determined by echocardiographic data. RESULTS: One hundred eight patients (49.5%) had clinical or echocardiographic findings for which prophylaxis was indicated. Of these 108 patients, 71 (65.7%) reported that they were instructed to take IE prophylaxis. Sixteen high-risk patients (88. 9%) but only 55 moderate-risk patients (61.1%) reported that they were instructed to take prophylaxis. Among the 110 negligible-risk patients, 29 (26.4%) reported that they had been instructed to take IE prophylaxis. Overall, 100 patients (45.9%) reported that they received physician instructions to take IE prophylaxis. Of those who subsequently underwent a procedure for which IE prophylaxis was indicated (n=68), 9 (13.2%) elected not to follow their physician's advice to take prophylaxis. CONCLUSIONS: We found that although most patients reported receiving instructions for IE prophylaxis use consistent with American Heart Association guidelines, IE prophylaxis overuse among negligible-risk patients and underuse among moderate-risk patients was common. Continued physician and patient education may lead to improved adherence to the current American Heart Association recommendations. JAMA. 2000;284:68-71

Duke Scholars

Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

July 5, 2000

Volume

284

Issue

1

Start / End Page

68 / 71

Location

United States

Related Subject Headings

  • Risk
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic
  • Patient Compliance
  • Middle Aged
  • Male
  • Humans
  • Guideline Adherence
  • General & Internal Medicine
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Seto, T. B., Kwiat, D., Taira, D. A., Douglas, P. S., & Manning, W. J. (2000). Physicians' recommendations to patients for use of antibiotic prophylaxis to prevent endocarditis. JAMA, 284(1), 68–71. https://doi.org/10.1001/jama.284.1.68
Seto, T. B., D. Kwiat, D. A. Taira, P. S. Douglas, and W. J. Manning. “Physicians' recommendations to patients for use of antibiotic prophylaxis to prevent endocarditis.JAMA 284, no. 1 (July 5, 2000): 68–71. https://doi.org/10.1001/jama.284.1.68.
Seto TB, Kwiat D, Taira DA, Douglas PS, Manning WJ. Physicians' recommendations to patients for use of antibiotic prophylaxis to prevent endocarditis. JAMA. 2000 Jul 5;284(1):68–71.
Seto, T. B., et al. “Physicians' recommendations to patients for use of antibiotic prophylaxis to prevent endocarditis.JAMA, vol. 284, no. 1, July 2000, pp. 68–71. Pubmed, doi:10.1001/jama.284.1.68.
Seto TB, Kwiat D, Taira DA, Douglas PS, Manning WJ. Physicians' recommendations to patients for use of antibiotic prophylaxis to prevent endocarditis. JAMA. 2000 Jul 5;284(1):68–71.
Journal cover image

Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

July 5, 2000

Volume

284

Issue

1

Start / End Page

68 / 71

Location

United States

Related Subject Headings

  • Risk
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic
  • Patient Compliance
  • Middle Aged
  • Male
  • Humans
  • Guideline Adherence
  • General & Internal Medicine
  • Female