Assessment of knowledge of guidelines for the prevention of infective endocarditis amongst clinicians in a teaching hospital

A significant minority of instances of endocarditis appear to be the result of invasive procedures pet-formed in susceptible patients with underlying cardiac conditions. Absence, or inappropriate administration, of antimicrob ial prophylaxis could expose the patient to the development of a potentiall y lethal infection. This study was formulated, therefore, to assess the kno wledge of guidelines for the prevention of infective endocarditis among hos pital-based physicians and surgeons. A multiple choice test was developed, including: (1) cardiac conditions at increased risk fur development of infe ction; (2) procedures more likely to be associated with bacteraemia and end ocarditis; and (3) type and route of antimicrobials prescribed when endocar ditis prophylaxis is indicated. The quality of the test was determined in s everal ways. Success was defined as a pass rate of 11 of 18 questions (61%) . The test was taken by 153 of 251 (60%) physicians employed by the hospita l; 95 (62%) passed the test. No significant difference in success rates was found according to ses, professional status or medical school. Internists performed substantially better (with a pass rate of 41 of 53, 77%) than bot h paediatricians (13 of 26, 50%, P < 0.05) and surgeons (41 of 74, 55%, P < 0.01). The range of success varied from 100% to 36% according to specialty (P < 0.001). The mean score was 69 +/- 21 in the study group and 94 +/- 10 in a control group of 20 infectious disease physicians (P < 0.001). In con clusion, this study demonstrates the need for improved education of hospita l-based clinicians regarding endocarditis prophylaxis recommendations. (C) 2000 The Hospital Infection society.