ROBERT G. NORFLEET, M.D.
To the editor: The letter of Goldman and associates (1) supplies important information about bacteremia after flexible sigmoidoscopy. Their study is well done, but I believe their conclusion—that patients with cardiac lesions predisposing to endocarditis should be treated with prophylactic antibiotics before flexible sigmoidoscopy—is in error for several reasons
First, a huge number of patients would have to be "protected"; 6.3% of American women have mitral valve prolapse (2). When persons with other valvular and congenital heart disease are added, there will be a very large expense for and risk from the antibiotics administered.
Second, the incidence of bacteremia reported
NORFLEET RG. Antibiotics Before Endoscopy. Ann Intern Med. ;98:416. doi: 10.7326/0003-4819-98-3-416_1
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Published: Ann Intern Med. 1983;98(3):416.
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