Prevention of infective endocarditis: not by antibiotics alone. A 7-year follow-up of 90 dental patients.

Ninety patients (thirty-nine men, fifty-one women with a mean age of 45.4 years with rheumatic heart disease or prosthetic heart valves, were subjected to a total of 1617 dental procedures, which required about 3400 patient/dentist encounters. All treatments were performed according to the protocol described in the present article. Although theory expects three to six cases of infective endocarditis cases in the described population, none of the patients have encountered the disease (p = 0.0013). A conceptual approach, as well as the protocol, is presented. Properly applied, the protocol will reduce the probability of iatrogenic and self-inflicted bacteremia, thus elevating the efficacy of the preventive process.