Appropriateness of Antibiotic Prophylaxis Before Dental Procedures, 2016–2018

2022 ◽  
Author(s):  
Colin C. Hubbard ◽  
Charlesnika T. Evans ◽  
Gregory S. Calip ◽  
Jifang Zhou ◽  
Susan A. Rowan ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Dental Procedures

scholarly journals Periprocedural Peritonitis Prophylaxis: A Summary of the Microbiology and the Role of Systemic Antimicrobials

2021 ◽  
Vol 7 (2) ◽  
pp. 90-99
Author(s):  
Leon Hsueh ◽  
Susie L. Hu ◽  
Ankur D. Shah
Keyword(s):  
Peritoneal Dialysis ◽  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Catheter Insertion ◽  
Antibiotic Regimen ◽  
Dental Procedures ◽  
Intravenous Antibiotics ◽  
Skin Flora ◽  
Potential Strategy

Background: Peritonitis is a leading complication of peritoneal dialysis (PD). One strategy that the International Society for Peritoneal Dialysis (ISPD) has used to help mitigate the morbidity and mortality associated with peritonitis is through prevention, including antibiotic prophylaxis utilization in high-risk situations. The aim of this study is to summarize our current understanding of postprocedural peritonitis and discuss the existing data behind periprocedural antibiotic prophylaxis, focusing primarily on PD catheter insertion, dental procedures, colonoscopies, upper endoscopies with gastrostomy, and gynecologic procedures. Summary: The ISPD currently recommends intravenous antibiotics prior to PD catheter insertion, colonoscopies, and invasive gynecologic procedures, though prophylaxis has only demonstrated benefit in a prospective, randomized control setting for PD catheter insertion. However, multiple retrospective studies exist that support the use of antibiotic prophylaxis for the other 2 procedures. No specific antibiotic regimen has been established as most optimal to prevent peritonitis for any of the 3 procedures. Antibiotic coverage should include the Enterobacteriaceae family, as well as Gram-positive organisms commonly found on the skin flora for PD catheter insertion, anaerobes for colonoscopies, and common organisms from the urogenital flora in gynecologic procedures. Additionally, the ISPD currently recommends oral amoxicillin prior to dental procedures. There is currently no ISPD recommendation to provide antibiotic prophylaxis prior to an upper endoscopy with or without gastrostomy, though this is a potential area for research. Key Messages: PD patients are at high risk for developing peritonitis after typical procedures. Antibiotic prophylaxis is a potential strategy that the ISPD utilizes to prevent these infections. However, further research needs to be done to determine the optimal antibiotic regimen.

scholarly journals Acute Hematogenous Infection of Revision Total Hip Arthroplasty by Oral Bacteria in a Patient without a History of Dental Procedures: Case Report

2014 ◽  
Vol 8 (1) ◽  
pp. 56-59 ◽  
Author(s):  
Motoki Sonohata ◽  
Masaru Kitajima ◽  
Syunsuke Kawano ◽  
Masaaki Mawatari
Keyword(s):  
Total Hip Arthroplasty ◽  
Antibiotic Prophylaxis ◽  
Hip Arthroplasty ◽  
Oral Bacteria ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Metastatic Infection ◽  
Dental Procedures ◽  
History Of ◽  
Joint Prostheses

The risk of periprosthetic joint infection from hematogenous bacterial seeding is increased in patients undergoing dental procedures that facilitate the development of bacteremia. We herein report the case of a patient without a history of dental procedures who suffered from an acute metastatic infection of a hip prosthesis by the oral bacterium Streptococcus mutans 18 months after undergoing revision total hip arthroplasty. The patient was successfully treated by two-stage revision surgery. It is important to realize that the efficacy of antibiotic prophylaxis against joint infections has not yet been convincingly proven. As a result, optimal dental hygiene and regular dental visits may be more important than antibiotic prophylaxis for maintaining joint health. Therefore, orthopedic surgeons should educate patients with joint prostheses about good oral health.

scholarly journals Patient perceptions of antibiotic prophylaxis for dental procedures after total joint arthroplasty

2020 ◽  
Vol 17 ◽  
pp. 22-24
Author(s):  
Niall H. Cochrane ◽  
Cole S. Pachter ◽  
Jonathan H. Garfinkel ◽  
Thomas B. Gladnick ◽  
Elizabeth P. Gladnick ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Patient Perceptions ◽  
Dental Procedures

scholarly journals Designing a customized clinical practice guideline regarding antibiotic prophylaxis for Iranian general dentists

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Najmeh Savadi ◽  
Omid Barati ◽  
Hossein Mirhadi ◽  
Ali Golkari
Keyword(s):  
Clinical Practice ◽  
Antibiotic Prophylaxis ◽  
Content Validity ◽  
Expert Panel ◽  
Joint Infection ◽  
Developed Countries ◽  
Local Context ◽  
Dental Procedures ◽  
Validity Indices ◽  
General Dentists

Abstract Background Clinical practice guidelines produced by developed countries seemed to be not completely feasible for developing countries due to their different local context. In this study, we designed a customized guideline about antibiotic prophylaxis before dental procedures for Iranian general dentists. Methods This study was conducted of two parts, including a qualitative part and a cross-sectional analytic part. A multidisciplinary team searched for related guidelines and other documents, selected the most updated and high quality ones, customized their recommendations based on available antibiotics in Iran, prepared a draft adapted guideline and summarized its recommendations in 3 flowcharts. An expert panel (20 specialists of four Iranian dental universities) participated in a consensus process, afterwards to determine the relevance and clarity of the flowcharts and their items. Then the Content Validity Indices (CVIs) were calculated and any items with CVI higher than 0.79 remained. Results The adapted recommendations were summarized in flowcharts A to C. Two separate groups of patients who need antibiotic prophylaxis were presented in flowchart A; including those with high risk for distant-site infection (infective endocarditis and prosthetic joint infection) and those at risk for poor healing and orofacial infection (due to impaired immunologic function). Flowcharts B and C described antibiotic regimen and also the dental procedures where antibiotic prophylaxis was needed for mentioned groups. The content validity indices and the percentages of agreement between the expert panel members were considerably high. Conclusions A localized, clear and straight forward guideline that addresses all groups of dental patients who need antibiotic prophylaxis has been produced for Iranian general dentists.

scholarly journals 1895. Serious Antibiotic-Related Adverse Effects Following Unnecessary Dental Prophylaxis in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S56-S56
Author(s):  
Alan E Gross ◽  
Katie J Suda ◽  
Jifang Zhou ◽  
Gregory Calip ◽  
Susan A Rowan ◽  
...  
Keyword(s):  
United States ◽  
Adverse Effects ◽  
Antibiotic Prophylaxis ◽  
Primary Endpoint ◽  
Cumulative Incidence ◽  
The United States ◽  
Risk Difference ◽  
Health Claims ◽  
Dental Visits ◽  
Dental Procedures

Abstract Background Dentists prescribe 10% of outpatient antibiotics in the United States, with a significant portion of these being for prophylaxis. We previously found that 80% of prescriptions for prophylaxis prescribed prior to dental visits are unnecessary; however, the sequelae of these unnecessary antibiotics have not been characterized. Our objective was to assess the harms of unnecessary antibiotic prophylaxis using Truven, a national health claims database. Methods This was a retrospective cohort study of patients with dental visits from 2011 to 2015 linked to medical and prescription claims. Patients with commercial dental insurance without a hospitalization or extra-oral infection 14 days prior to antibiotic prophylaxis (≤2 days supply dispensed within 7 days before a dental visit) were assessed for inclusion. Patients with unnecessary antibiotic prophylaxis (defined as antibiotic prophylaxis in patients who both did not undergo a procedure that manipulated the gingiva/tooth periapex and did not have an appropriate cardiac diagnosis) were included and assessed for serious antibiotic-related adverse effects (AAE). The primary endpoint was the cumulative incidence of any AAE within 14 days post-prescription (composite of allergy, anaphylaxis, C. difficile infection, or ED visit). The secondary analyses were the cumulative incidence of each individual AAE and the risk difference of the primary endpoint between amoxicillin and clindamycin. Results Of the 168,420 dental visits with antibiotic prophylaxis, 136,177 (80%) were unnecessary and included for analysis. 3.8% of unnecessary prescriptions were associated with an AAE; primary and secondary endpoints are listed in the Table. ED visits (1.2%) and new allergies (2.9%) were most frequent. Clindamycin was associated with more AAE than amoxicillin (risk difference 322.1 per 1000 person-years, 95% CI: 238.5 - 405.8). Conclusion Even though antibiotic prophylaxis is prescribed for a short duration (≤2 days), it is not without risk. Since most AAE are diagnosed in medical settings, dentists may not be aware of these adverse effects. These data provide further impetus to decrease unnecessary prescribing of antibiotic prophylaxis prior to dental procedures. Disclosures All Authors: No reported Disclosures.

Drug cost implications for antibiotic prophylaxis for dental procedures

2013 ◽  
Vol 115 (3) ◽  
pp. 345-353 ◽  
Author(s):  
Peter B. Lockhart ◽  
Joe Blizzard ◽  
Andréa L. Maslow ◽  
Michael T. Brennan ◽  
Howell Sasser ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Drug Cost ◽  
Dental Procedures ◽  
Cost Implications
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