Antibiotic prophylaxis may not be indicated for prevention of dental implant infections in healthy patients. A systematic review and meta-analysis

Khouly, Ismael; Braun, Rosalie Salus; Chambrone, Leandro

doi:10.1007/s00784-018-2762-x

Cited by 28 publications

(28 citation statements)

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“…This statement becomes controversial in the case of healthy patients, due to the inherent risks of treatment with antimicrobials, such as hypersensitivity reactions, direct toxicity, and opportunistic bacterial infections, as well as the proliferation of multidrug-resistant bacteria, which can reduce the effectiveness of the treatment. Conversely, other authors [ 22 , 28 ] have concluded that antimicrobials should not be prescribed as prophylaxis to prevent failures in implantology. Given these findings, and in light of the associated risks of antibiotics for both individual and public health [ 29 ], a reassessment of the routine prescription of prophylaxis in dental implant placement procedures is required.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Prescription Habits of Dentists Performing Dental Implant Treatments in Santo Domingo, Dominican Republic

Aragoneses

Brugal

et al. 2020

Antibiotics

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The use of antibiotics in implant treatments is controversial. The purpose of this research was to study the behaviors of Santo Domingo dentists who prescribe antimicrobials to patients for the placement of dental implants. A total of 99 dentists participated in the study. A share of 1.2% of dentists prescribed antimicrobials solely in the preoperative period, 8.6% after surgery, 44.4% before and after, 19.8% only in specific situations, and 25.9% did not prescribe at all. Amoxicillin was the predominant antimicrobial of choice. A cross-sectional, observational, survey-based study was conducted. The items studied were demographics, self-assessment of knowledge about antibiotics and when they are used, as well as their recommended dosage and duration, in healthy and non-allergic patients. Notable variability was found in the prescription behaviors of antimicrobials. Bridging gaps in knowledge on the subject could help to standardize prescription guidelines.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Prescription Habits of Dentists Performing Dental Implant Treatments in Santo Domingo, Dominican Republic

Aragoneses

Brugal

et al. 2020

Antibiotics

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“…Antibiotic resistance driven by antibiotic misuse is considered a world public issue, which is deemed to be among one of the most severe world health problems according to the reports from the Centers for Disease, Control and Prevention (Centers for Disease Control & Prevention, 2019; Dayer, Chambers, Prendergast, Sandoe, & Thornhill, 2013; Fleming‐Dutra et al, 2016; Gutschik & Lippert, 1990; Khouly, Braun, & Chambrone, 2019; Soheilipour et al, 2011). It has been estimated that up to 30% of prescribed antibiotics are unnecessary (Fleming‐Dutra et al, 2016; Khalil, Hultin, Fred, Olsson, & Lund, 2015; Soheilipour et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…It has been estimated that up to 30% of prescribed antibiotics are unnecessary (Fleming‐Dutra et al, 2016; Khalil, Hultin, Fred, Olsson, & Lund, 2015; Soheilipour et al, 2011). Among dentists, there is a lack of consensus about antibiotic prescription (Khouly et al, 2019); in addition, one of the most recent reviews on the use of antibiotics in dentistry (Marchionni et al, 2017) has pointed out that for simple tooth extractions the use of antibiotics could increase the risks of the medication's adverse effects without significantly preventing postoperative complications. Above all, it turned out that dentists frequently prescribed antibiotics in medically compromised patients, who—according to the current guidelines—no longer need antibiotic prophylaxis (Colterjohn, Beer, Petruccelli, Zabtia, & Winemaker, 2014; Dar‐Odeh, Fadel, Abu‐Hammad, Abdeljawad, & Abu‐Hammad, 2018; Dayer et al, 2013; Khouly et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Among dentists, there is a lack of consensus about antibiotic prescription (Khouly et al, 2019); in addition, one of the most recent reviews on the use of antibiotics in dentistry (Marchionni et al, 2017) has pointed out that for simple tooth extractions the use of antibiotics could increase the risks of the medication's adverse effects without significantly preventing postoperative complications. Above all, it turned out that dentists frequently prescribed antibiotics in medically compromised patients, who—according to the current guidelines—no longer need antibiotic prophylaxis (Colterjohn, Beer, Petruccelli, Zabtia, & Winemaker, 2014; Dar‐Odeh, Fadel, Abu‐Hammad, Abdeljawad, & Abu‐Hammad, 2018; Dayer et al, 2013; Khouly et al, 2019). What is even more peculiar is that some authors identified non‐clinical factors—such as pressure from the patient or the family physician—that could influence the dentists in prescribing antibiotics (Dayer et al, 2013; Soheilipour et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

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Antibiotic’s effectiveness after erupted tooth extractions: A retrospective study

et al. 2020

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Objective The purpose of this retrospective study was to assess the influence of antibiotics on the development of alveolitis after tooth extractions. Materials and Methods The study population consisted of patients who had erupted tooth extractions in 3 centers. The patients’ medical records were collected for several parameters. Moreover, use of antibiotics was evaluated. The primary outcome was the development of alveolitis during the postoperative period. The secondary outcome measure was the possible associations between alveolitis and other patients’ characteristics. Results A total of 1579 patient charts were screened. The patients enrolled in the study were 418 (159 males and 259 females). Alveolitis was reported for 12 extraction sites (2.87%). Six were in the group of patients that received antibiotics (2.14% out of 280 patients treated with antibiotics), and six were in the group of patients that did not receive antibiotics (4.35% out of 138 patients not receiving antibiotics). None of patient‐level parameters showed any significant association with the development of alveolitis. Conclusion In conclusion, this study showed that the use of antibiotics after erupted tooth extractions is not useful in preventing alveolitis. Larger, prospective, and randomized studies are needed before incorporating these findings into the daily clinical practice.

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“…Recent studies have concluded that the administration of systemic antibiotics does not significantly reduce early implant failure in simple implant surgeries (defined as surgeries without broad flaps or simultaneous bone regeneration) in healthy patients ( Mazzocchi et al, 2007 ; Lund et al, 2015 ; Romandini et al, 2019 ). Moreover, local infections after dental implant placement do not benefit from the administration of systemic antibiotics ( Khouly et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Prescription of Antibiotic Prophylaxis for Dental Implant Surgery in Healthy Patients: A Systematic Review of Survey-Based Studies

2021

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Background: Systemic antibiotic prophylaxis is frequently prescribed by dentists performing dental implant surgery to avoid premature implant failure and postoperative infections. The scientific literature suggests that a single preoperative dose suffices to reduce the risk of early dental implant failure in healthy patients.Material and Methods: A systematic review was made based on an electronic literature search in the PubMed-Medline, Embase, Web of Science, Scopus and Open Gray databases. The review addressed the question: “which antibiotic prophylaxis regimens are being used in dental implant surgery in healthy patients according to survey-based studies?” The identification, screening, eligibility and inclusion phases were conducted according to the PRISMA statement by two independent reviewers. The following data were collected: country, number of surveyed dentists, number of dentists who responded (n), response rate, routine prescription of antibiotic prophylactic treatment (yes, no, or conditioned prescription), prescription regimen (preoperative, perioperative or postoperative) and antibiotic choice (first and second choice). Cohen’s kappa coefficient (k) evaluated the level of agreement between the two reviewers. The analysis of risk of bias was performed follow the Joanna Briggs Institute checklist for observational studies. A descriptive statistical analysis was performed to calculate total target sample, sample size and total mean.Results: A total of 159 articles were identified, of which 12 were included in the analysis. Two thousand and seventy-seven dentists from nine different countries on three continents were surveyed. The median response rate was low and disparate between studies. About three-quarters of the surveyed dentists claimed to routinely prescribe systemic antibiotic prophylaxis for dental implant surgery. The prescription regimen was perioperative, postoperative and preoperative, in decreasing order of frequency. The most frequent first choice drug was amoxicillin, with amoxicillin-clavulanic acid as second choice.Conclusions: A majority of dentists from different countries do not prescribe systemic antibiotic prophylaxis for dental implant surgery following the available scientific evidence and could be overprescribing. Efforts are needed by dental educators and professionals to reduce the gap between the use of antibiotic prophylaxis for dental implant surgery as supported by the scientific evidence and what is being done by clinicians in actual practice.

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Antibiotic prophylaxis may not be indicated for prevention of dental implant infections in healthy patients. A systematic review and meta-analysis

Cited by 28 publications

References 55 publications

Antimicrobial Prescription Habits of Dentists Performing Dental Implant Treatments in Santo Domingo, Dominican Republic

Antimicrobial Prescription Habits of Dentists Performing Dental Implant Treatments in Santo Domingo, Dominican Republic

Antibiotic’s effectiveness after erupted tooth extractions: A retrospective study

Prescription of Antibiotic Prophylaxis for Dental Implant Surgery in Healthy Patients: A Systematic Review of Survey-Based Studies

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