The evidence base for the efficacy of antibiotic prophylaxis in dental practice

Lockhart, Peter B.; Loven, Bridget; Brennan, Michael T.; Fox, Philip C.

doi:10.14219/jada.archive.2007.0198

Cited by 146 publications

(110 citation statements)

References 139 publications

(143 reference statements)

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“…12,13 In the light of these facts, we highlight some actions that ought to be adhered to in order to reduce the risks in the practice of dentistry: (I) cleaning, disinfection and sterilization; (II) the usage of barriers and protective equipment; (III) immunization; (IV) prevention and handling of occupational hazards; (V) antisepsis. 14,15 However, the literature shows that these actions are not always seriously implemented by professionals despite of their relevance and the large number of publications related to this subject. [1][2][3]10 Towards that end, to obtain effective control of contamination in dentistry environments it is necessary to further educate on health and raise awareness of professionals to the risks of exposure, as well as to the prevention of transmitted pathogens, through accurate and updated information.…”

Section: Discussionmentioning

confidence: 99%

The assessment of infection control in dental practices in the municipality of São Paulo

Matsuda¹,

Grinbaum²,

Davidowicz³

2011

Braz J Infect Dis

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Objective: The goal of this study was to evaluate the infection control measures actually implemented by dental surgeons during dental practice, as patients and professionals are exposed to high biological risk in dental care environments. Method: 614 questionnaires (90.69%) were answered by professionals registered in updating or in post-graduate courses in the Municipality of São Paulo. Results: Out of surveyed professionals 30.62% admitted that surface protection barriers were not used, whereas 34.17% were using non ideal or outdated pre-disinfection practices. The autoclave was used by 69.38% of participants, although 33.80% were not monitoring control of the sterilization cycles. Chemical and biological indicators were not used simultaneously by 83.21% of respondents and were not employed on a daily or weekly basis by at least 81.75%. Dubious methods of sterilization were cited by 44.77%. Occupational accidents caused by cutting and piercing objects were reported by 47.88%; however, the biologic risk was underestimated by 74.15% of the professionals who suffered the accidents. Irritant solutions were used as an antiseptic agent by 18.55%. Conclusions: Infection control measures reported by dental surgeons during their practices are defi cient. It is necessary to educate, raise awareness of professionals, and promote constant updating courses on procedures which aim at improving safety of dental care.

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Section: Discussionmentioning

confidence: 99%

The assessment of infection control in dental practices in the municipality of São Paulo

Matsuda¹,

Grinbaum²,

Davidowicz³

2011

Braz J Infect Dis

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“…Moreover, several of those studies are not primarily focused on infection, although they contain information on infected patients [11,13,17,18,24,36,40,45,46]. Finally, the level of evidence in many of them is low; we have found seven case series (Level of Evidence IV) [3,6,13,16,17,21,40,46] and many nonsystematic reviews (Level of Evidence V) [1,18,23,25,28,34,38,45] and expert opinions (Level of Evidence V) [2,4,30]. We believe it important to learn and identify these risk factors in the individual patient for to check for and minimize risk factors or, when not possible to consider specific prophylactic measures.…”

Section: Introductionmentioning

confidence: 97%

“…Dislocation [36] and hematoma [37] are accepted risk factors, whereas the influence of prolonged drainage is debated [15,32,36,37]. Cutaneous [5] and urinary tract [2,4,20,36] infections are risk factors for hematogenous seeding, but the role of respiratory and abdominal infections is debated [20] as well as that of metastatic infection from oral or dental origin [21,23,30].…”

Section: Introductionmentioning

confidence: 99%

What Are the Risk Factors for Infection in Hemiarthroplasties and Total Hip Arthroplasties?

Cordero‐Ampuero

Dios

2010

Clinical Orthopaedics &Amp; Related Research

161

103

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Background Late infection is the second most frequent early complication after total hip arthroplasty (THA) and the most frequent after hemiarthroplasty. Known risk factors for infection after THA include posttraumatic osteoarthritis, previous surgery, chronic liver disease, corticoid therapy, and excessive surgical time. However, risk factors for hemiarthroplasty are not clearly established. Questions/purposes We therefore determined the preoperative and intraoperative risk factors for late infection (more than 3 months after surgery) in patients with hemiarthroplasties and THAs. Methods We retrospectively compared 47 patients with a hip arthroplasty (23 hemiarthroplasties, 24 total hip arthroplasties) and late infection with 200 randomlyselected patients with primary arthroplasty (100 hemiarthroplasties, 100 total hip arthroplasties) during the same time period of time without any infection during followup. Potential risk factors were identified from medical records. Minimum followup was 12 months (mean, 27 months; range, 12-112 months) for the study group and 18 months (mean, 84 months; range, 18-144 months) for the control group. Results The following factors were more frequent in late infected hemiarthroplasties: female gender; previous surgery; obesity (body mass index greater than 30 kg/m 2 ); glucocorticoid and immunosuppressant treatments; prolonged surgical time; inadequate antibiotic prophylaxis; prolonged wound drainage; hematoma; dislocation; and cutaneous, urinary, and/or abdominal infections. The following were more frequent in infected total hip arthroplasties: posttraumatic osteoarthritis; previous surgery; glucocorticoids; chronic liver disease; alcohol and intravenous drug abuse; prolonged surgical time; prolonged wound drainage; dislocation; subsequent surgery; and cutaneous, urinary, respiratory and abdominal infections. Diabetes did not appear to be a risk factor. Conclusions Our data suggest there are specific risk factors for infection in hemiarthroplasties.

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“…[8][9][10] However, controversy concerning the efficacy and safety of antibiotic prophylaxis has been under debate for many decades. [11][12][13] Current evidence suggests that dental procedures play a minor role in the development of infective endocarditis and periprosthetic joint infection. [14][15][16][17][18][19] Increased awareness of antibiotic resistance has also questioned the appropriateness and scope of antibiotic prophylaxis use in dentistry.…”

Section: Introductionmentioning

confidence: 99%

Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners

Spittle¹,

Muzzin²,

Campbell³

et al. 2017

The Journal of Contemporary Dental Practice

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Aim: Antibiotic prophylaxis guidelines have been developed for health care and dentistry. The authors examined whether dentists were following the 2007 American Heart Association (AHA) and the 2012 American Association of Orthopaedic Surgeons (AAOS) recommendations for antibiotic prophylaxis. Materials and methods:A survey was sent to 600 dentists in the south-central region of the United States. The survey examined dentists' prescribing practices for patients with cardiac and prosthetic joint replacements, antibiotic regimen prescribed, confidence in their prescription decisions, and dentistry's contribution to antibiotic resistance. Results:The response rate was 28.7% (n = 172). Dentists followed the 2007 AHA guidelines for patients with a history of infective endocarditis (95%), and cardiac valves repaired with prosthetic materials (76%) or animal/donor tissue (61%). For prosthetic joint replacement, 72% prescribed antibiotic prophylaxis within the first 2 years after placement and 58% continued to prescribe after 2 years. Amoxicillin was the most frequently prescribed antibiotic for cardiac conditions (92%) and prosthetic joint replacements (77%). No significant differences were found in relation to dentists' gender (p = 0.75), year of graduation (p = 0.71), scope of practice (p = 0.30), and their confidence in their prescription decisions; 73% believed taking multiple doses of antibiotics leads to antibiotic resistance. Conclusion:The majority of dentists were following the 2007 AHA guidelines. Confusion regarding the 2012 AAOS guidelines for prosthetic joint replacement was evident.Clinical significance: Keeping current with changing antibiotic prophylaxis guidelines ensures dentists are providing the best evidence-based dentistry for their patients.

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The evidence base for the efficacy of antibiotic prophylaxis in dental practice

Cited by 146 publications

References 139 publications

The assessment of infection control in dental practices in the municipality of São Paulo

The assessment of infection control in dental practices in the municipality of São Paulo

What Are the Risk Factors for Infection in Hemiarthroplasties and Total Hip Arthroplasties?

Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners

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