“…Moreover, transient bacteremia can be also determined by tooth brushing with a major cumulative exposure risk with respect to invasive dental procedures [ 22 ]. Furthermore, there is a large number of case reports describing IE that developed many months after dental procedures with no detection of oral streptococci in endocardium lesions (reviewed in [ 31 ]). In 2008, on the basis of these evaluations, the National Institute for Health and Care Excellence (NICE) of the UK recommended that antibiotics should not be given routinely for IE prevention in the case of dental procedures to adults and children at risk of IE [ 32 ].…”
Section: Antibiotic Prophylaxis For Dental Procedures In Patients At Risk For Infectionmentioning
The antimicrobial resistance (AMR) phenomenon is an emerging global problem and is induced by overuse and misuse of antibiotics in medical practice. In total, 10% of antibiotic prescriptions are from dentists, usually to manage oro-dental pains and avoid postsurgical complications. Recent research and clinical evaluations highlight new therapeutical approaches with a reduction in dosages and number of antibiotic prescriptions and recommend focusing on an accurate diagnosis and improvement of oral health before dental treatments and in patients’ daily lives. In this article, the most common clinical and operative situations in dental practice, such as endodontics, management of acute alveolar abscesses, extractive oral surgery, parodontology and implantology, are recognized and summarized, suggesting possible guidelines to reduce antibiotic prescription and consumption, maintaining high success rates and low complications rates. Additionally, the categories of patients requiring antibiotic administration for pre-existing conditions are recapitulated. To reduce AMR threat, it is important to establish protocols for treatment with antibiotics, to be used only in specific situations. Recent reviews demonstrate that, in dentistry, it is possible to minimize the use of antibiotics, thoroughly assessing patient’s conditions and type of intervention, thus improving their efficacy and reducing the adverse effects and enhancing the modern concept of personalized medicine.
“…Moreover, transient bacteremia can be also determined by tooth brushing with a major cumulative exposure risk with respect to invasive dental procedures [ 22 ]. Furthermore, there is a large number of case reports describing IE that developed many months after dental procedures with no detection of oral streptococci in endocardium lesions (reviewed in [ 31 ]). In 2008, on the basis of these evaluations, the National Institute for Health and Care Excellence (NICE) of the UK recommended that antibiotics should not be given routinely for IE prevention in the case of dental procedures to adults and children at risk of IE [ 32 ].…”
Section: Antibiotic Prophylaxis For Dental Procedures In Patients At Risk For Infectionmentioning
The antimicrobial resistance (AMR) phenomenon is an emerging global problem and is induced by overuse and misuse of antibiotics in medical practice. In total, 10% of antibiotic prescriptions are from dentists, usually to manage oro-dental pains and avoid postsurgical complications. Recent research and clinical evaluations highlight new therapeutical approaches with a reduction in dosages and number of antibiotic prescriptions and recommend focusing on an accurate diagnosis and improvement of oral health before dental treatments and in patients’ daily lives. In this article, the most common clinical and operative situations in dental practice, such as endodontics, management of acute alveolar abscesses, extractive oral surgery, parodontology and implantology, are recognized and summarized, suggesting possible guidelines to reduce antibiotic prescription and consumption, maintaining high success rates and low complications rates. Additionally, the categories of patients requiring antibiotic administration for pre-existing conditions are recapitulated. To reduce AMR threat, it is important to establish protocols for treatment with antibiotics, to be used only in specific situations. Recent reviews demonstrate that, in dentistry, it is possible to minimize the use of antibiotics, thoroughly assessing patient’s conditions and type of intervention, thus improving their efficacy and reducing the adverse effects and enhancing the modern concept of personalized medicine.
“…Patel et al. beschrieben in einem Fallbericht sogar eine Patientin, die ohne Risikofaktoren vor der zahnärztlichen Behandlung eine Antibiotikaprophylaxe einnahm und trotzdem eine infektiöse Endokarditis entwickelte [ 38 ]. Im Umkehrschluss, unter Berücksichtigung möglicher Arzneimittelinteraktionen Mögliche Arzneimittelinteraktionen , konnte auch eine Häufung von Todesfällen durch die Prophylaxepraxis errechnet werden (z.…”
Für die Effektivität und Effizienz einer antibiotischen Prophylaxe vor zahnmedizinischen Eingriffen zum Schutz vor einer infektiösen Endokarditis liegt nur eine geringe Evidenz vor, die keine Rechtfertigung zur generalisierten Therapie von Patienten mit einem erhöhten Endokarditisrisiko darstellt. Aktuelle Leitlinien empfehlen daher, Antibiotika im Rahmen der Endokarditisprophylaxe auf Patienten zu beschränken, die zum einen ein hohes Risiko für die Entstehung einer infektiösen Endokarditis aufweisen und die sich zum anderen zahnärztlichen Eingriffen mit höchstem Endokarditisrisiko unterziehen. Einen hohen Stellwert besitzen allerdings auch Mund- und Hauthygienemaßnahmen, die nicht nur auf Risikopatienten, sondern auch auf die Allgemeinbevölkerung angewendet werden sollten, da die Inzidenz der infektiösen Endokarditis bei Patienten ohne anamnestisch bekannte Herzerkrankung zunehmend ansteigt.
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