Abstract
We read with interest the recent editorial by Chambers et al. 1 Like the authors we strongly support antibiotic prophylaxis in at least the high-risk population but have met with resistance from local dental practices who invariably quote NICE guidelines in their defence. However, we noted that the resistance to prescribing antibiotics was variable despite the guidelines being in place for three years. To establish current practice, we undertook a telephone and email survey of 200 randomly selected dental practices in all counties of Great Britain. A response rate of 46.5% (93/200) was generated. Ninety-six percent of the responders reported being aware of NICE guidelines. However, 37% still prescribed prophylactic antibiotics contradictory to recommendations of NICE. On detailed questioning, there remained ambiguity about which patients constituted the high-risk group. Only 21% and 15% correctly identified congenital heart disease and postoperative valve replacement, respectively, as being high-risk patients. Interestingly, 6% of those surveyed still prescribed antibiotics to all preoperative and postoperative open-heart surgery patients.
Three years have passed since NICE recommended no antibiotic prophylaxis irrespective of risk profile in direct contrast to international guidelines. 2 However, it appears the message is yet to infiltrate the dental ranks or indeed there is dissent among the ranks. All is therefore not lost. If the respective societies can ‘re-educate’ the dentists on the relative merits of prophylaxis at least in the high-risk group, we may still get the message across.
Footnotes
Competing interests
None declared