International Consensus on a Dental Antibiotic Stewardship Core Outcome Set

Thompson, Wendy; Teoh, Leanne; Pulcini, Céline; Sanderson, Susie; Williams, David; Carter, Vanessa; Pitkeathley, Carole; Walsh, Tanya

doi:10.1016/j.identj.2023.03.006

Cited by 5 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, the present microbiological surveillance data better inform dental professionals in the United States about antibiotic resistance trends in the major human periodontal pathogen P. gingivalis and may serve as part of a new antibiotic resistance baseline for dental antibiotic stewardship programs in the United States [85]. Additional populationspecific surveillance monitoring is needed in the United States and other countries to further track the development of antibiotic resistance among periodontitis-associated bacterial species.…”

Section: Discussionmentioning

confidence: 95%

Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients

Rams,

Sautter,

van Winkelhoff

2023

Antibiotics

View full text Add to dashboard Cite

Antibiotic resistance patterns of the major human periodontal pathogen Porphyromonas gingivalis were assessed over a 20-year period in the United States. Subgingival P. gingivalis was cultured pre-treatment from 2193 severe periodontitis patients during three time periods: 1999–2000 (936 patients), 2009–2010 (685 patients), and 2019–2020 (572 patients). The clinical isolates were tested for in vitro resistance to 4 mg/L for clindamycin and doxycycline, 8 mg/L for amoxicillin, and 16 mg/L for metronidazole, with a post hoc combination of data for metronidazole plus amoxicillin. Clindamycin-resistant P. gingivalis was significantly more prevalent in 2009–2010 (9.1% of patients) and 2019–2020 (9.3%; 15-fold increase) as compared to 1999–2000 (0.6%). P. gingivalis resistance to amoxicillin also significantly increased from 0.1% of patients in 1999–2000 to 1.3% in 2009–2010 and 2.8% (28-fold increase) in 2019–2020. P. gingivalis resistance to metronidazole, metronidazole plus amoxicillin, and doxycycline was low (≤0.5% prevalence), and statistically unchanged, over the 20-year period. These findings are the first to reveal marked increases over 20 years in clindamycin-resistant and amoxicillin-resistant P. gingivalis in United States periodontitis patients. Increased antibiotic resistance of P. gingivalis and other periodontitis-associated bacteria threatens the efficacy of periodontal antimicrobial chemotherapy.

show abstract

Section: Discussionmentioning

confidence: 95%

Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients

Rams,

Sautter,

van Winkelhoff

2023

Antibiotics

View full text Add to dashboard Cite

show abstract

“…DHCWs should be educated and made aware of the minimal outcomes to be achieved in dental antibiotic stewardship with national-level guidelines being set out. 43 , 44 …”

Section: Discussionmentioning

confidence: 99%

Knowledge, Practices, and Nasal Carriage Rate of MRSA Amongst Dental Professionals

Jaber,

Kamate,

Luke

et al. 2024

International Dental Journal

View full text Add to dashboard Cite

“…For example, COS have been developed for post‐COVID‐19 conditions in adults (Munblit et al., 2022), for rheumatology (Boers et al., 2014) and trials of surgery (Macefield et al., 2014). COS has also been developed specifically for dentistry, including orthodontic clinical trials (Tsichlaki et al., 2020), dental antibiotic stewardship (Thompson et al., 2023), implant dentistry clinical trials (Tonetti et al., 2023) and traumatic dental injuries (Kenny et al., 2018).…”

Section: Discussionmentioning

confidence: 99%

An international consensus study to identify “what” outcomes should be included in a core outcome set for endodontic treatments (COSET) for utilization in clinical practice and research

El Karim,

Duncan,

Cushley

et al. 2023

Int Endodontic J

View full text Add to dashboard Cite

BackgroundDevelopment of a standardized set of topic‐specific outcomes known as a Core Outcome Set (COS) is important to address issues of heterogeneity in reporting research findings in order to streamline evidence synthesis and clinical decision making.AimThe aim of the current international consensus study is to identify “what” outcomes to include in the Core Outcome Set for Endodontic Treatments (COSET). Outcomes of various endodontic treatments (non‐surgical root canal treatment, surgical endodontics, vital pulp treatment and revitalization procedures) performed on permanent teeth were considered.MethodsA standard validated methodology for COS development and reporting was adopted. The process involved identification of existing outcomes through four published scoping reviews. This enabled creation of a list of outcomes to be prioritized via semi‐structured patient interviews, e‐Delphi process and a consensus meeting with a range of relevant global stakeholders. Outcomes were prioritized using a 1–9 Likert scale, with outcomes rated 7–9 considered critical, 4–6 are important and 1–3 are less important. Outcomes rated 7–9 by ≥70% and 1–3 by <15% of participants were considered to achieve consensus for inclusion in the COS. The outcomes that did not achieve consensus in the first round were considered for further prioritization in the second Delphi round and consensus meeting. Final decisions about the outcomes to include in COSET were made by voting during the consensus panel meeting using the Zoom Poll function.ResultsA total of 95 participants including patients contributed to the COS development process. The consensus panel recommended, with strong consensus, eight outcomes shared across all treatment modalities for inclusion in COSET: pain; signs of infection (swelling, sinus tract); further intervention/exacerbation; tenderness to percussion/palpation; radiographic evidence of disease progression/healing; function; tooth survival; and patient satisfaction. Additional treatment specific outcomes were also recommended.DiscussionMany of the outcomes included in COSET are patient reported. All should be included in future outcomes studies.ConclusionCOSET identified outcomes that are important for patients and clinicians and validated these using a rigorous methodology. Further work is ongoing to determine “how” and “when” these outcomes should be measured.

show abstract

International Consensus on a Dental Antibiotic Stewardship Core Outcome Set

Cited by 5 publications

References 27 publications

Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients

Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients

Knowledge, Practices, and Nasal Carriage Rate of MRSA Amongst Dental Professionals

An international consensus study to identify “what” outcomes should be included in a core outcome set for endodontic treatments (COSET) for utilization in clinical practice and research

Contact Info

Product

Resources

About