Noncompliance in the treatment of endocarditis. The medical staff as co-conspirators.

B A Schindler, Dept. of Psychiatry, Drexel University College of Medicine
D Blum
R Malone


Intravenous drug abusers with endocarditis present difficult problems in both medical and psychiatric management. A retrospective chart survey revealed that eight of nine such patients with endocarditis signed out against medical advice before antibiotic therapy was completed. Reasons for premature discharge included the patient's underlying psychopathology as well as the emotional response of the staff to these patients. Understanding both of these factors may help to prevent these premature discharges.