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Heart and dental care

People with heart valve problems are generally advised to take antibiotics before dental cleaning to reduce the risk of serious infection. But many who need the drugs do not take them, sometimes because their doctors never offer advice about them and may not even realize that the antibiotics are warranted, according to a recent report. //Researchers have put forward a simple suggestion that they say may increase compliance with the antibiotic recommendations. The researchers say that echocardiogram reports should routinely tell doctors whether their patients are candidates for antibiotics.

The problem now is that many doctors who refer patients for echocardiograms are not experts in reading them and are unclear when the heart association guidelines call for antibiotics, said Dr. Warren J. Manning of Harvard and Beth Israel Deaconess Medical Centre in Boston. Patients are often referred for echocardiograms after their doctors hear heart murmurs.

The test reveals whether the murmur is insignificant or is the result of a valve problem. If it is a valve problem, many patients should take antibiotics before a number of medical procedures, most commonly teeth cleaning but also colonoscopies. Without antibiotics, bacteria introduced into the body in those procedures can travel through the blood to the heart, causing potentially deadly infections. In the study, conducted over six months, the researchers divided more than 1,400 echocardiogram patients into two group. One had an antibiotics reminder printed on the reports; the other did not. Surveyed later, the patients in the first group were more likely to report compliance with the guidelines.


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