Prevention of infective endocarditis: Not by antibiotics alone

Tzukert, A.; Leviner, E.; Sela, Michael

doi:10.1016/0030-4220(86)90286-0

Cited by 42 publications

(21 citation statements)

References 15 publications

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“…chlorhexidine and povidone-iodine) used prior to certain dental procedures may reduce the prevalence and severity of bacteraemias. 37,38 The American Heart Association recommend use of local irrigation with chlorhexidine before treatment that can result in a bacteraemia. Whether such a procedure is sufficient to prevent infective endocarditis in either high or moderate risk patients has yet to be determined.…”

Section: Efficacy Of Antibiotic Prophylaxis In the Prevention Of Iementioning

confidence: 99%

Infective endocarditis, dentistry and antibiotic prophylaxis; time for a rethink?

et al. 2000

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Section: Efficacy Of Antibiotic Prophylaxis In the Prevention Of Iementioning

confidence: 99%

Infective endocarditis, dentistry and antibiotic prophylaxis; time for a rethink?

et al. 2000

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“…15 In a further study the annual mortality rate of IE of dental origin in the general community was compared with the incidence attributable to antibiotic prophylaxis in patients with rheumatic cardiopathy undergoing dental treatment. 50 They found that in a population of 100 million people there would be approximately 26 deaths attributed to IE associated with dental treatment. However, if 100 million people with rheumatic cardiopathy went to their dentist once per year, and were administered penicillin prophylactic cover, then there would be approximately 4000 deaths.…”

Section: Clinical Trials On Effectiveness and Safetymentioning

confidence: 99%

Antibiotic prophylaxis for endocarditis: time to reconsider

Singh

Straznicky

Avent

et al. 2005

Australian Dental Journal

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Some cardiac conditions require antibiotic prophylaxis for some types of dental treatment to reduce the risk of infective endocarditis (IE). All medical and dental practitioners are familiar with this practice but tend to use different regimens in apparently similar circumstances. Generally, the trend has been to prescribe antibiotics if in doubt. This review explores the evidence for antibiotic prophylaxis to prevent IE: does it work and is it safe? The changing nature of IE, the role of bacteraemia of oral origin and the safety of antibiotics are also reviewed. Most developed countries have national guidelines and their points of similarity and difference are discussed. One can only agree with the authority who describes antibiotic guidelines for endocarditis as being ‘like the Dead Sea Scrolls, they are fragmentary, imperfect, capable of various interpretations and (mainly) missing!’ Clinical case‐controlled studies show that the more widely antibiotics are used, the greater the risk of adverse reactions exceeding the risk of IE. However, the consensus is that antibiotic prophylaxis is mandatory for a small number of high‐risk cardiac and high‐risk dental procedures. There are a large number of low‐risk cardiac and dental procedures in which the risk of adverse reactions to the antibiotics exceeds the risk of IE, where prophylaxis should not be provided. There is an intermediate group of cardiac and dental procedures for which careful individual evaluation should be made to determine whether IE or antibiotics pose the greater risk. These categories are presented. All medical and dental practitioners need to reconsider their approach in light of these current findings.

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“…If there is concern about a dentalinduced bacteraemia, then chlorhexidine mouthwash 1-2 minutes before the procedure is likely to be more effective than antibiotic prophylaxis. 22 3. It has been recommended elsewhere 23 that if an orthopaedic surgeon still insists upon prophylaxis being provided then ask him to administer the drugs.…”

Section: Resultsmentioning

confidence: 99%