THE USE OF ANTIBIOTIC-PROPHYLAXIS IN RADIOLOGY DEPARTMENTS FOR PATIENTS AT HIGH-RISK OF INFECTIVE ENDOCARDITIS

Patients with a prosthetic heart valve, or a history of endocarditis a re at particular risk of developing infective endocarditis during a ba cteraemia which may follow many gastrointestinal and genito-urinary ra diological procedures. The current British Society for Antimicrobial C hemotherapy guidelines (1992) do recommend antibiotic prophylaxis for these high-risk patients prior to instrumentation of the gastrointesti nal or genito-urinary tracts. Routine antibiotic prophylaxis for patie nts with damaged native valves or heart murmurs is recommended prior t o dental procedures only. A questionnaire enquiring about prescribing practice prior to several radiological investigations known to be asso ciated with bacteraemia was sent to 192 radiology departments and 126 replied. Only 38 of the 126 respondents have a prescribing policy for antibiotic prophylaxis in high-risk groups. Fifty-eight departments em ploy antibiotic prophylaxis prior to one or more of the procedures nam ed in the questionnaire, but only 30 of these have mechanisms for iden tifying at-risk patients. Forty-eight departments keep recommended ant ibiotics in the department.