Physicians’ knowledge and practice attitudes toward infective endocarditis antibiotic prophylaxis guidelines in Saudi Arabia

Abstract

ObjectivesTo assess the physicians’ knowledge and practice attitudes toward the infective endocarditis antibiotics prophylaxis guidelines in Saudi Arabia. Moreover, to determine whether there is knowledge-to-practice discrepancy.MethodsA cross-sectional study was performed using a self-administered questionnaire. A questionnaire was distributed among physicians dealing with congenital heart disease patients in Saudi Arabia, from January 7, 2016 to August 30, 2016. The questionnaire designed to calculate three scores: a knowledge score, a practice score, and a knowledge-to-practice discrepancy score. A t test was used for a mean comparison between the three scores and a Pearson correlation coefficient for correlation.ResultsA total of 121 physicians completed the survey. The respondents were predominantly pediatric cardiologists (84%). The mean knowledge score for infective endocarditis prophylaxis in various cardiac lesions was 8.6 ± 3.2 SD out of 14, and the mean practice score was 7.6 ± 3 SD out of 14. The mean discrepancy score was 1.1 ± 3 SD. There was a positive significant correlation between knowledge and discrepancy scores, r = 0.533, n = 121, p = 0.001, using Pearson correlation analysis. Almost 39% of our population had a discrepancy score of +1 or more.ConclusionsThe knowledge about antibiotics prophylaxis of infective endocarditis in various cardiac lesions was less than optimal. Even in the presence of knowledge, there is a practice-to-knowledge discrepancy, with an overprescribing attitude for low-risk cardiac lesions that correlates significantly with more knowledgeable physicians. We recommend that physicians be up-to-date and follow the most recent guidelines.

Perception Regarding the NICE Guideline on Antibiotic Prophylaxis against Infective Endocarditis Following Dental Procedures: A Cross-Sectional Study

“…Many still seek advice from cardiologists instead of referring to the guidelines before prescribing AP to patients [ 10 , 11 , 19 ]. This study showed that most microbiologists recommend adhering to the NICE guidelines, a finding that concurs with the Saudi Arabian study [ 20 ].…”

“…Dayer et al [ 10 ] included microbiologists and infectious disease specialists alongside dental specialists, cardiothoracic surgeons and cardiologists in their survey, while Soheilipour et al [ 19 ] (UK) and Rı’orda’in and McCreary [ 11 ] (Ireland) included cardiologists and dentists in their studies. In addition, Alhuzaimi et al [ 20 ] assessed the knowledge and practice attitudes of cardiologists and cardiothoracic surgeons towards the IE AP guidelines in Saudi Arabia.…”

“…Dayer et al [ 10 ] found that clinicians gave the opinion that patients with a prosthetic heart valve or previous history of IE should receive AP. On the contrary, Alhuzaimi et al [ 20 ] reported an overprescribing attitude for low-risk cardiac lesions. Meanwhile, many studies have shown that dentists are still uncertain about prescribing AP [ 10 , 11 , 19 ].…”

Practical aspects of infective endocarditis prevention

“…Эффективная профилактика ИЭ предполагает понимание этиологии, механизмов развития заболевания, оценку категорий пациентов, имеющих высокий риск его возникновения и доскональное знание самих превентивных мероприятий [21]. Несмотря на доступность и относительную простоту рекомендаций по АБП ИЭ, практические врачи, сталкивающиеся с группами больных, имеющими риск развития ИЭ, в целом недостаточно осведомлены о практических аспектах предупреждения заболевания, о чём свидетельствуют результаты исследований зарубежных коллег [22][23][24][25][26][27][28][29]. Целью представленного обзора является освещение различных аспектов ИЭ, касающихся, прежде всего, практических подходов к его профилактике.…”