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August 22, 1977

Antimicrobial Therapy

JAMA. 1977;238(8):852-853. doi:10.1001/jama.1977.03280090016003

To the Editor.—  I most welcome the efforts of the Veterans Administration Ad Hoc Interdisciplinary Advisory Committee on Antimicrobial Drug Usage in reviewing the indications and selections of drugs used for surgical and nonsurgical prophylaxis. As this represents a very complex and difficult problem with many unresolved controversies, physicians are often confused about the pros and cons of antibiotic prophylaxis in many instances.Furthermore, in areas where the indications for prophylaxis are well accepted and standardized, we still find many detrimental omissions or inadequacies. For example, after seeing a patient with known valvular heart disease being affected with two episodes of endocarditis secondary to dental manipulations without antibiotic prophylaxis, we did a random phone survey and found out that only 1/10 dentists in our community gave antibiotic prophylaxis that is considered appropriate by the American Heart Association.The members of the VA ad hoc committee expertly reviewed the appropriateness of