Sir, we should no longer give penicillin cover to rheumatic fever patients and the like; such patients are five times more likely to suffer a fatal reaction to the antibiotic than they are to die of endocarditis.

These are the inferences I draw from the latest edition of Evidence Based Dentistry (EBD 2004, 5: 46). It seems to me that it would be irresponsible, and risking litigation, to continue the established practice of giving the antibiotic cover. Are we all agreed on this?