Safe administration of contrast media: what do physicians know?

Background: Radiographic contrast media (RCM) are among the most commonly used materials in medicine. Nevertheless, there seems to be a little agreement between current practice and accepted guidelines regarding their adverse reactions, the indications for premedication, and use of low-osmolar contrast agents (LOCAs). Misconceptions exist regarding the relationship between hypersensitivity to RCM and foods and medications that contain iodine. Objective: To evaluate physicians' knowledge, misconceptions, and attitudes regarding the use of RCM and the prevention of their adverse reactions. Methods: Physicians from university-affiliated general hospitals were asked to complete an anonymous questionnaire on RCM. Results: A total of 157 physicians (45%), including radiologists, internists, pediatricians, surgeons, and primary family physicians, agreed to participate. All physicians demonstrated limited knowledge regarding adverse effects of RCM and the patients who might be at increased risk of developing them. Most physicians were not familiar with accepted guidelines for using premedication and LOCAs. Misconceptions regarding the association between the use of drugs or foods that contain iodine and adverse effects to RCM were common among all physicians. Conclusions: The level of knowledge about the adverse reactions of RCM among physicians is unsatisfactory, which may result in unwarranted use of expensive LOCAs or premedication in healthy patients. Alternatively, physicians' failure to use these measures when indicated may endanger patients. Despite the lack of association between adverse effects to RCM and safe consumption of iodine-containing substances, physicians continue to harbor these misconceptions. Educational programs that may improve physicians' knowledge are urgently needed.