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 Micromonas micros Infection of a Prosthetic Hip Joint: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Abhimanyu Aggarwal ◽  
Durane Walker
Keyword(s):  
Antibiotic Prophylaxis ◽  
Hip Joint ◽  
Joint Infection ◽  
Dental Procedure ◽  
Joint Infections ◽  
Prosthetic Joints ◽  
Prosthetic Joint ◽  
Dental Procedures ◽  
Prosthetic Joint Infections ◽  
Hematogenous Seeding

Micromonas micros is an oral anaerobic Gram-positive coccus and is a commensal of the mouth, and it is rarely isolated in prosthetic joint infections (PJIs) and even less frequently related to a preceding dental procedure with eventual hematogenous seeding of the prosthetic joint. Here, we present a case of a 56-year-old male with a prosthetic hip joint who developed Micromonas micros prosthetic hip joint infection with symptoms starting a few days after a dental procedure and not having received periprocedural antibiotic prophylaxis. He recovered well with surgical intervention and antimicrobial therapy. We conducted a literature review of prosthetic hip joint infections caused by Micromonas micros as well as briefly discuss current guidelines on antibiotic prophylaxis in patients with prosthetic joints undergoing dental procedures and some knowledge gaps.

Prosthetic Joint Infection Following Invasive Dental Procedures and Antibiotic Prophylaxis in Patients With Hip or Knee Arthroplasty

2016 ◽  
Vol 38 (2) ◽  
pp. 154-161 ◽  
Author(s):  
Feng-Chen Kao ◽  
Yao-Chun Hsu ◽  
Wen-Hui Chen ◽  
Jiun-Nong Lin ◽  
Ying-Ying Lo ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prosthetic Joint Infection ◽  
Cox Regression ◽  
Dental Treatment ◽  
Joint Infection ◽  
Prophylactic Antibiotics ◽  
Prosthetic Joint ◽  
Dental Procedures ◽  
Cohort Difference ◽  
Increased Risk

OBJECTIVESWe aimed to clarify whether invasive dental treatment is associated with increased risk of prosthetic joint infection (PJI) and whether prophylactic antibiotics may lower the infection risk remain unclear.DESIGNRetrospective cohort study.PARTICIPANTSAll Taiwanese residents (N=255,568) who underwent total knee or hip arthroplasty between January 1, 1997, and November 30, 2009, were screened.METHODSThe dental cohort consisted of 57,066 patients who received dental treatment and were individually matched 1:1 with the nondental cohort by age, sex, propensity score, and index date. The dental cohort was further divided by the use or nonuse of prophylactic antibiotics. The antibiotic and nonantibiotic subcohorts comprised 6,513 matched pairs.RESULTSPJI occurred in 328 patients (0.57%) in the dental subcohort and 348 patients (0.61%) in the nondental subcohort, with no between-cohort difference in the 1-year cumulative incidence (0.6% in both, P=.3). Multivariate-adjusted Cox regression revealed no association between dental procedures and PJI. Furthermore, PJI occurred in 13 patients (0.2%) in the antibiotic subcohort and 12 patients (0.18%) in the nonantibiotic subcohorts (P=.8). Multivariate-adjusted analyses confirmed that there was no association between the incidence of PJI and prophylactic antibiotics.CONCLUSIONSThe risk of PJI is not increased following dental procedure in patients with hip or knee replacement and is unaffected by antibiotic prophylaxis.Infect Control Hosp Epidemiol. 2017;38:154–161

scholarly journals Is there a Role for Antibiotic Prophylaxis Prior to Dental Procedures in Patients with Total Joint Arthroplasty? A Systematic Review of the Literature

2020 ◽  
Vol 5 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Pablo Ariel Slullitel ◽  
José Ignacio Oñativia ◽  
Nicolás Santiago Piuzzi ◽  
Carlos Higuera-Rueda ◽  
Javad Parvizi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Prophylaxis ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Joint Infection ◽  
Prophylactic Antibiotics ◽  
Review Of The Literature ◽  
Dental Procedures ◽  
Current Systematic Review ◽  
Cochrane Database

Abstract. Background: The indication of prophylactic antibiotics prior to dental procedures for non-infected causes in order to reduce the risk of haematogenous periprosthetic joint infection (PJI) remains as controversial. We performed a systematic review of the literature assessing the relationship between PJI and invasive dental procedures and whether there is evidence to support the use of antibiotic prophylaxis.Methods: This review was conducted in accordance with the 2009 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for studies focusing on dental procedures after TJA, reporting on PJI as an outcome. The methodological quality was assessed with the Newcastle-Ottawa quality assessment scale for case-control and cohort studies and by the tool proposed by Murad et al. for observational studies.Results: Our systematic literature review yielded 90 individual studies, of which 9 met the inclusion criteria. The overall infection rate ranged from 0.26% to 2.12%. Of these, cases associated with a dental procedure ranged from 0% to 15.9%. Five of the studies described cases in which antibiotic prophylaxis was administered; however, no clear algorithm regarding type and dosage of antibiotic was mentioned. When assessing the methodological quality of the evidence, all studies had an overall low to moderate quality.Conclusion: The current systematic review, mostly composed of low-quality studies, suggests that there is no direct evidence to indicate prophylactic antibiotics prior to dental procedures in patients with TJA. In line with the current guidelines, no prophylaxis should be used on interventions for non-infected causes, except for occasional unusual situations, which can then be judged individually.

scholarly journals Translation, Cross-Cultural Adaptation, and Validation of The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Into Japanese

2020 ◽  
Author(s):  
Noyuri Yamaji ◽  
Sachiko Ohde ◽  
Osamu Takahashi ◽  
Saki Muroya ◽  
Tsuguya Fukui
Keyword(s):  
Content Validity ◽  
Expert Panel ◽  
Healthcare Providers ◽  
Face Validity ◽  
Local Context ◽  
Validity And Reliability ◽  
The Face ◽  
Hospital Consumer Assessment ◽  
Discharged Patients ◽  
Consumer Assessment

Abstract Background: Patient-centred healthcare is important, and patient experiences are considered a central pillar of quality in healthcare. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS®) is an instrument used to quantitatively evaluate patient perspectives. This study's objective was to conduct the translation and adaptation of the HCAHPS® into Japanese and to determine the validity and reliability of the translated version.Methods: We translated the original English HCAPHS® into Japanese based on standardized guidelines. The content validity was assessed by an expert panel of eight members and 12 discharged patients. The discharged patients assessed the face validity. We assessed the average of all raters’ evaluations at the item level (I-CVI and I-FVI) and the scale level (S-CVI and S-FVI). We evaluated each item and the entire questionnaire, with cut-off points of 0.78 for the I-CVI and I-FVI and 0.9 for the S-CVI and S-FVI.Results: Regarding the content validity, the S-CVI was 0.99, and the I-CVIs for the individual items ranged from 0.95 to 1.0. Regarding the face validity, the I-FVIs of all items except for Q26 were 0.78 or higher. The S-FVIs were 0.96 for clarity and 0.98 for comprehension. The expert panel reviewed the translated Japanese version of the HCAHPS and modified it based on the patient raters' feedback.Conclusions: The translated HCAHPS® content is well adapted to the local context. Until now, there has been no standard instrument to measure the perspectives of hospitalized patients in Japan. The translated HCAHPS® is expected to have utility for measuring the quality of health indicators.Trial registration:No applicable.

scholarly journals Knowledge of Moroccan Dentists Towards the Prophylaxis of Infective Endocarditis

2018 ◽  
Vol 5 ◽  
Author(s):  
Hajar Ben Mohimd ◽  
Fatima Zaoui ◽  
Bassima Chami ◽  
Wafae El Wady
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Antibiotic Prophylaxis ◽  
Analytical Study ◽  
Heart Association ◽  
Cross Sectional ◽  
Dental Procedures ◽  
Level Of Knowledge ◽  
General Dentists ◽  
The City

Background: The involvement of oral bacterias in the occurrence of infective endocarditis (IE) has prompted the adoption of antibiotic prophylaxis prior to dental procedures for patients at high-risk. The aim of this paper was to assess the knowledge of Moroccan dentists regarding the management of patients with heart disease at risk of infective endocarditis.Methods: This was a cross-sectional descriptive analytical study which targeted 200 dentists in the city of Rabat- Morocco. A questionnaire with 16 questions was distributed randomly. The level of knowledge of dentists was established based on the number of correct answers for each section and responses were assessed according to the American Heart Association (AHA) 2007 guidelines.Results: Only 133 practitioners have agreed to participate in our study with a response rate of 66,5%. 87% of dentists reported contacting the cardiologist before starting treatment, 33% of practitioners weren’t aware of any guidelines and 20% knew AHA 2007, 52% reported not following guidelines in the management of patients with heart disease. Among the cardiac conditions and dental procedures proposed in the questionnaire which required prophylaxis; 8% and 2% respectively chose the correct answer according to the AHA’s 2007 guidelines. 31% of dentists answered correctly on the prescription of antibiotic prophylaxis protocol according to the latest recommendations.Conclusion: According to our results, the knowledge of Moroccan private general dentists towards endocarditis prophylaxis was in a low level. The study highlights the need for continuous education.

scholarly journals Knowledge of Moroccan Dentists Towards the Prophylaxis of Infective Endocarditis

2018 ◽  
Vol 5 (r) ◽  
Author(s):  
Hajar BEN MOHIMD ◽  
Fatima ZAOUI ◽  
Bassima CHAMI ◽  
Wafae EL WADY
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Antibiotic Prophylaxis ◽  
Analytical Study ◽  
Heart Association ◽  
Cross Sectional ◽  
Dental Procedures ◽  
Level Of Knowledge ◽  
General Dentists ◽  
The City

Background: The involvement of oral bacterias in the occurrence of infective endocarditis (IE) has prompted the adoption of antibiotic prophylaxis prior to dental procedures for patients at high-risk. The aim of this paper was to assess the knowledge of Moroccan dentists regarding the management of patients with heart disease at risk of infective endocarditis. Methods: This was a cross-sectional descriptive analytical study which targeted 200 dentists in the city of Rabat- Morocco. A questionnaire with 16 questions was distributed randomly. The level of knowledge of dentists was established based on the number of correct answers for each section and responses were assessed according to the American Heart Association (AHA) 2007 guidelines. Results: Only 133 practitioners have agreed to participate in our study with a response rate of 66,5%. 87% of dentists reported contacting the cardiologist before starting treatment, 33% of practitioners weren’t aware of any guidelines and 20% knew AHA 2007, 52% reported not following guidelines in the management of patients with heart disease. Among the cardiac conditions and dental procedures proposed in the questionnaire which required prophylaxis; 8% and 2% respectively chose the correct answer according to the AHA’s 2007 guidelines. 31% of dentists answered correctly on the prescription of antibiotic prophylaxis protocol according to the latest recommendations. Conclusion: According to our results, the knowledge of Moroccan private general dentists towards endocarditis prophylaxis was in a low level. The study highlights the need for continuous education.

scholarly journals Viewpoint: Periprosthetic joint infection and dental antibiotic prophylaxis guidelines

2021 ◽  
Vol 6 (8) ◽  
pp. 363-366
Author(s):  
Miao Xian Zhou ◽  
Elie F. Berbari ◽  
Cory G. Couch ◽  
Scott F. Gruwell ◽  
Alan B. Carr
Keyword(s):  
Infectious Disease ◽  
Antibiotic Prophylaxis ◽  
Periprosthetic Joint Infection ◽  
Mayo Clinic ◽  
Joint Infection ◽  
Orthopedic Surgeons ◽  
Dental Procedures

Abstract. The purpose of this viewpoint is to provide a framework that is used within the Mayo Clinic to align recommendations from infectious disease experts, dental specialists, and orthopedic surgeons with regards to need for antibiotic prophylaxis prior to invasive dental procedures.

scholarly journals Management of Hepatocellular Carcinoma in Japan: JSH Consensus Statements and Recommendations 2021 Update

Liver Cancer ◽  
2021 ◽  
pp. 1-43
Author(s):  
Masatoshi Kudo ◽  
Yusuke Kawamura ◽  
Kiyoshi Hasegawa ◽  
Ryosuke Tateishi ◽  
Kazuya Kariyama ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Practice ◽  
Public Relations ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Expert Panel ◽  
Clinical Practices ◽  
Fourth Edition ◽  
Level Of Evidence ◽  
Consensus Statements

The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other’s work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC.

scholarly journals Current and Emerging Pharmacotherapeutic Options for Smoking Cessation

2013 ◽  
Vol 7 ◽  
pp. SART.S8108 ◽  
Author(s):  
Kristin V. Carson ◽  
Malcolm P. Brinn ◽  
Thomas A. Robertson ◽  
Rachada To-A-Nan ◽  
Adrian J. Esterman ◽  
...  
Keyword(s):  
Developing Countries ◽  
Smoking Cessation ◽  
Clinical Practice ◽  
Chronic Disease ◽  
Developed Countries ◽  
Mental Illnesses ◽  
Current Clinical Practice ◽  
Efficacy And Safety ◽  
First Line ◽  
Marginalized Groups

Tobacco smoking remains the single most preventable cause of morbidity and mortality in developed countries and poses a significant threat across developing countries where tobacco use prevalence is increasing. Nicotine dependence is a chronic disease often requiring multiple attempts to quit; repeated interventions with pharmacotherapeutic aids have become more popular as part of cessation therapies. First-line medications of known efficacy in the general population include varenicline tartrate, bupropion hydrochloride, nicotine replacement therapy products, or a combination thereof. However, less is known about the use of these products in marginalized groups such as the indigenous, those with mental illnesses, youth, and pregnant or breastfeeding women. Despite the efficacy and safety of these first line pharmacotherapies, many smokers continue to relapse and alternative pharmacotherapies and cessation options are required. Thus, the aim of this review is to summarize the existing and developing pharmacotherapeutic and other options for smoking cessation, to identify gaps in current clinical practice, and to provide recommendations for future evaluations and research.

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