Infective endocarditis: the impact of the nice guidelines for antibiotic prophylaxis

Thornhill, Martin H

doi:10.12968/denu.2012.39.1.6

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…The question in this discussion is also the legitimacy of prophylactic administration of antibiotics for the prevention of infectious endocarditis (IE). It should be noted that in 2008 the National Institute for Health and Clinical Excellence (NICE) recommended terminating antibiotic prophylaxis before dental procedures in the UK and there has not been an increased incidence in IE upto 2012. There is a lack of evidence for the efficacy of penicillin in the prophylaxis of IE and it is also unclear whether the potential harms and costs of antibiotic administration outweigh the benefit.…”

Section: Discussionmentioning

confidence: 99%

The trends in antibiotic use by general dental practitioners in the Czech Republic (2006–2012)

Pipalova

Vlcek

Slezák

2014

International Dental Journal

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We assessed antibiotic prescribing in practical dentistry in the Czech Republic, as antibiotics are widely prescribed by dental practitioners and warning signals of their overuse can be observed. The individual antibiotic prescriptions were extracted from the database of the General Health Insurance Company and further analysed. The proportion of dentists' prescription within the whole primary health-care sector and the rate of prescriptions of particular antibiotics were both in defined daily doses per 1,000 insurees and day (DID) and in number of prescriptions calculated. The proportion of antibiotic use in dentistry increased from 0.63 DID in 2006 to 0.75 DID. We found a decline in use of narrow-spectrum penicillins by 4.8%, tetracyclines by 3.5% and macrolides by 3.6%, accompanied by increasing rate of prescription of aminopenicillins combined with beta-lactamase inhibitor by 8.9% and lincosamides by 8.5%. The consumption of clindamycin and amoxicillin combined with clavulanate in DID has increased by approximately 60% since 2006 thanks to the exclusive prescribing of two commercial oral products only. Factors contributing to this unfavourable trend are commercial influence or defensive medicine practice.

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Section: Discussionmentioning

confidence: 99%

The trends in antibiotic use by general dental practitioners in the Czech Republic (2006–2012)

Pipalova

Vlcek

Slezák

2014

International Dental Journal

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“…Reasons for excluding papers from the review comprised a lack of intervention[ 57 , 58 ], wrong outcome measures[ 59 , 60 ] and wrong study design (ecological studies)[ 52 , 53 ]. One debate paper[ 61 ], early-stage trials and those without published findings were also excluded. [ 42 , 62 ] Findings of one of the later trials were published during the review process, thus this publication could be included in our review.…”

Section: Resultsmentioning

confidence: 99%

The effect of interventions aiming to optimise the prescription of antibiotics in dental care—A systematic review

Löffler

Böhmer

2017

PLoS ONE

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BackgroundAbundant evidence in dentistry suggests that antibiotics are prescribed despite the existence of guidelines aiming to reduce the development of antibiotic resistance. This review investigated (1) which type of interventions aiming to optimise prescription of antibiotics exist in dentistry, (2) the effect of these interventions and (3) the specific strengths and limitations of the studies reporting on these interventions.MethodLiterature search was based on Medline, Embase, Global Health, Cochrane CENTRAL, ClinicalTrials.gov and Current Controlled Trials. Studies with one of the two primary outcomes were included: (1) The number of antibiotics prescribed and/or (2) the accuracy of the prescription, commonly measured as a percentage of adherence to local clinical guidelines.ResultsNine studies met these inclusion criteria. Five studies reported on the prescription of antibiotics in primary dental care and four studies focused on outpatient dental care. Interventions used in primary dental care included a combination of audit, feedback, education, local consensus, dissemination of guidelines and/or academic detailing. Trials in the outpatient setting made use of expert panel discussions, educational feedback on previous acts of prescribing, the dissemination of guidelines and the establishment of internal guidelines. All studies successfully reduced the number of antibiotics prescribed and/or increased the accuracy of the prescription. However, most studies were confounded by a high risk of selection bias, selective outcome reporting and high variance across study groups. In particular, information relating to study design and methodology was insufficient. Only three studies related the prescriptions to the number of patients treated with antibiotics.ConclusionsThis systematic review was able to offer conclusions which took the limitations of the investigated studies into account. Unfortunately, few studies could be included and many of these studies were confounded by a low quality of scientific reporting and lack of information regarding study methodology. High-quality research with objective and standardised outcome reporting, longer periods of follow-up, rigorous methodology and adequate standard of study reporting is urgently needed.

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“…It is necessary to exercise caution if the patient has caries or periodontal disease and is susceptible to bacteraemia. Therefore, dentists must understand the role of dental diseases in the development of IE and secondary headaches [6]. Here, we describe a rare case of IE with secondary headache.…”

Section: Introductionmentioning

confidence: 94%

Infective Endocarditis With Secondary Headache: A Case Report

Takizawa¹,

Ozasa²,

Matsumoto³

et al. 2022

Cureus

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Secondary headache is a symptom of an underlying disease. Infective endocarditis (IE) is a serious infection of the heart tissue. Herein, we present a rare case of IE, with a secondary headache. The patient presented with persistent headache, fever of 39°C, myalgia, and painful erythema of the plantar surface of the foot. The headache progressively worsened over a few weeks. She was diagnosed with secondary headache, and sepsis was suspected. Blood culture revealed the presence of Streptococcus viridans, leading to a diagnosis of IE. Postoperatively, the patient recuperated without any complications. Headaches can be secondary to other conditions. Therefore, comprehensive assessment and accurate diagnosis are essential. Dentists must be aware that headache is a concomitant symptom of IE.

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Infective endocarditis: the impact of the nice guidelines for antibiotic prophylaxis

Cited by 10 publications

References 23 publications

The trends in antibiotic use by general dental practitioners in the Czech Republic (2006–2012)

The trends in antibiotic use by general dental practitioners in the Czech Republic (2006–2012)

The effect of interventions aiming to optimise the prescription of antibiotics in dental care—A systematic review

Infective Endocarditis With Secondary Headache: A Case Report

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