scholarly journals Prosthetic joint infection, dental treatment and antibiotic prophylaxis

2009 ◽  
Vol 1 (1) ◽  
pp. 7 ◽  
Author(s):  
Marthinus J. Kotzé
Keyword(s):  
South Africa ◽  
Antibiotic Prophylaxis ◽  
Dental Treatment ◽  
Oral Surgery ◽  
Joint Infection ◽  
Prophylactic Antibiotic ◽  
Working Party ◽  
Heart Association ◽  
British Society ◽  
Joint Prostheses

Current international and national prophylactic antibiotic regimens have been analyzed in respect of the prevention of bacteremia after dental and surgical procedures and, therefore, of joint prosthesis infection. This information was used to formulate guidelines for the Department of Maxillofacial and Oral Surgery. Publications since 2003 were used in this research. In addition, recommendations of accredited institutions and associations were examined. These included the guidelines of the American Dental Association in association with the American Academy of Orthopaedic Surgeons (2003), the American Heart Association (2007), the Working Party of the British Society for Antimicrobial Chemotherapy (2006) and the Australian Dental Guidelines (2005). No guidelines published by any institution in South Africa were found. The general rationale for the use of antibiotic prophylaxis for surgical (including dental) interventions is that those procedures may result in a bacteremia that may cause infection in joint prostheses. Antibiotics, however, should therefore be administered to susceptible patients, e.g. immunocompromised patients, prior to the development of bacteremia. The guidelines recommended for use in South Africa are based solely on those used outside South Africa. South Africa is regarded as a developing country with its own population and demographic characteristics. Eleven percent of our population is infected with HIV, and a specific guideline for prophylactic antibiotic treatment is, therefore, essential.

Case against antibiotic prophylaxis for dental treatment of patients with joint prostheses

The Lancet ◽  
1992 ◽  
Vol 339 (8788) ◽  
pp. 301 ◽  
Author(s):  
N.A. Simmons ◽  
A.P. Ball ◽  
R.A. Cawson ◽  
S.J. Eykyn ◽  
S.P.F. Hughes ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Dental Treatment ◽  
Joint Prostheses

Outcomes Associated with Restored and Unrestored Deciduous Molar Teeth

2002 ◽  
Vol os9 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Keith M Milsom ◽  
Martin Tickle ◽  
David King ◽  
Paula Kearney-Mitchell ◽  
Anthony S Blinkhorn
Keyword(s):  
Dental Treatment ◽  
Working Party ◽  
British Society ◽  
North West ◽  
The North ◽  
Dental Practitioners ◽  
History Of ◽  
Molar Teeth ◽  
Deciduous Molar ◽  
Deciduous Molars

Introduction Most dental treatment for children in the United Kingdom (UK) is provided by general dental practitioners (GDPs) working in the National Health Service (NHS). A working party of the British Society of Paediatric Dentistry, in a special publication from the Dental Practice Board, has suggested that failure to provide restorative care for the deciduous dentition is unacceptable, yet GDPs are filling fewer teeth in young children. The study aimed to evaluate the health outcomes obtained from restoring carious deciduous molar teeth. Method The dental records of 677 children cared for by 50 GDPs in the north west of England were analysed. Results The results showed that 18.8% of deciduous molars with unrestored caries and 17.0% with a history of restorative care went on to be extracted because of pain or sepsis. Conclusion The results suggest that the risk of carious deciduous molars being extracted is similar whether these teeth receive restorative care or not.

Antibiotic prophylaxis of endocarditis: new recommendations

1990 ◽  
Vol 28 (23) ◽  
pp. 90-91
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Prophylaxis ◽  
Antimicrobial Chemotherapy ◽  
Working Party ◽  
British Society ◽  
General Anaesthetic ◽  
Oral Doses ◽  
Erythromycin Stearate ◽  
Gram Positive Cocci ◽  
Dental Work

The Endocarditis Working Party of the British Society for Antimicrobial Chemotherapy has recently updated its recommendations for the antibiotic prophylaxis of infective endocarditis (Endocarditis Working Party, BSAC, Lancet 1990; 335: 88–89). This follows reports of nausea after large oral doses of erythromycin stearate, previously recommended for patients allergic to penicillin who are having dental work without a general anaesthetic. An alternative, clindamycin is now introduced. This antibiotic is very active against Gram-positive cocci, the most important organisms. These are the new recommendations.

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 Duration of Prophylactic Antibiotic and Prosthetic Joint Infection in a Developing Country: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Keerati Chareancholvanich ◽  
Chaturong Pornrattanamaneewong ◽  
Pakpoom Ruangsomboon ◽  
Waiwit Sanguanwongwan ◽  
Piyanuch Musikachart ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Developing Country ◽  
Infection Rate ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Prophylactic Antibiotic ◽  
Hospital Length Of Stay ◽  
Perioperative Antibiotic Prophylaxis ◽  
The Difference ◽  
Extended Course

Abstract BackgroundPerioperative antibiotic prophylaxis is one of the standard measures for preventing periprosthetic joint infection (PJI). In developing countries, poor surgical environment and patient hygiene are often cited as reasons for prolonged antibiotic duration without any evidence to support its effectiveness. The aim of this study was to investigate the infection rate after TKA compared between standard course (≤24 hours) and extended course (>24 hours) of perioperative antibiotic prophylaxis in a developing country.MethodsThis retrospective study included patients who underwent unicompartmental knee arthroplasty or total knee arthroplasty during January 2013 to December 2018. A total of 3,316 patients were included. Of those, 1,284 and 2,032 patients received standard and extended course of antibiotic prophylaxis, respectively. The incidence of PJI was compared between groups, and we also analyzed for factors significantly associated with PJI.ResultsPJI developed in 0.5% (6/1,284) of the standard course group, and in 1.2% (24/2,032) of the extended course group. The difference and 95% confidence interval for the difference between groups was -0.714% (-1.338% to -0.043%), which confirms the noninferiority status of the standard course group compared to the extended course group. Longer hospital length of stay significantly associated with higher infection rate (p=0.000). Postoperative wound infection was not found to be associated with age, body mass index, American Society of Anesthesiologists classification, blood transfusion, or surgery type.ConclusionTwenty-four hours of perioperative antibiotic prophylaxis was found to be adequate for PJI prevention in a developing country setting.Trial registrationEthical approval and consent to participate: The study was approved by the Institutional review board of Siriraj Hospital, Mahidol university. [SIRB 847/2559(EC3)]

scholarly journals Infective Endocarditis Prophylaxis in Patients Undergoing Oral Surgery

2016 ◽  
Vol 20 (1) ◽  
pp. 5-14 ◽  
Author(s):  
M. Zoumpoulakis ◽  
F. Anagnostou ◽  
S. Dalampiras ◽  
L. Zouloumis ◽  
C. Pliakos
Keyword(s):  
Infective Endocarditis ◽  
Oral Surgery ◽  
Heart Association ◽  
Clinical Excellence ◽  
British Society ◽  
Prophylactic Measures ◽  
Adjacent Structures ◽  
Management Of Complications ◽  
Bacteria And Fungi ◽  
European Society Of Cardiology

SummaryInfective endocarditis (IE), an infection of the endocardium that usually involves the valves and adjacent structures, may be caused by a wide variety of bacteria and fungi that entered the bloodstream and settled in the heart lining, a heart valve or a blood vessel. The IE is uncommon, but people with some heart conditions have a greater risk of developing it. Despite advances in medical, surgical, and critical care interventions, the IE remains a disease that is associated with considerable morbidity and mortality. Hence, in order to minimize the risk of adverse outcome and achieve a yet better management of complications, it is crucial to increase the awareness of all the prophylactic measures of the IE.For the past 50 years, the guidelines for the IE prophylaxis have been under constant changes. The purpose of this paper is to review current dental and medical literature considering the IE prophylaxis, including the new and updated guidelines from the American Heart Association (AHA, 2007 and 2015), the National Institute for Health and Clinical Excellence (NICE, 2015), the European Society of Cardiology (ESC, 2009 and 2015) and the British Society for Antimicrobial Chemotherapy (BSAC, 2006).

scholarly journals A Review of Guidelines for Antibiotic Prophylaxis before Invasive Dental Treatments

2020 ◽  
Vol 11 (1) ◽  
pp. 311
Author(s):  
Abdulaziz A. Bakhsh ◽  
Husain Shabeeh ◽  
Francesco Mannocci ◽  
Sadia Ambreen Niazi
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
European Society ◽  
Clinical Guideline ◽  
Dental Treatment ◽  
Heart Association ◽  
Clinical Effectiveness ◽  
Cardiac Patients ◽  
High Dose ◽  
Nice Clinical Guideline

Bacteraemia associated with invasive dental treatments can propagate infective endocarditis in high-risk cardiac patients. Over the past decade, antibiotic prophylaxis before dental treatment has been questioned. This review aims to compare the variations between the UK, European and American antibiotic prophylaxis guidelines before dental treatments. Antibiotic prophylaxis guidelines by the National Institute for Health and Care Excellence (NICE)—Clinical Guideline 64, Scottish Dental Clinical Effectiveness Programme (SDCEP), American Heart Association (AHA), European Society of Cardiology (ESC), European Society of Endodontology (ESE) and Belgian Health Care Knowledge Centre (KCE) position statements were compared regarding the indications, high-risk patients and prophylaxis regimens before dental treatments. In the United Kingdom, the NICE—Clinical Guideline 64 and SDCEP—Implementation Advice do not advise the prescription of prophylactic antibiotics for the majority of high-risk cardiac patients undergoing routine dental treatments. On the contrary, the AHA, ESC and KEC recommend the prescription of antibiotics prior to invasive dental procedures in high-risk cardiac individuals. The ESE also indicates prophylaxis before endodontic procedures for patients with other conditions, including impaired immunologic function, prosthetic joint replacement, high-dose jaw irradiation and intravenous bisphosphonates. Among these guidelines, there are variations in antibiotic prophylaxis regimens. There are variations regarding the indications and antibiotic prophylaxis regimens before invasive dental treatments among these available guidelines.

Infective Endocarditis Associated with Orthodontic Treatment: A Case Report

1993 ◽  
Vol 20 (3) ◽  
pp. 241-244 ◽  
Author(s):  
R. S. Hobson ◽  
J.D. Clark
Keyword(s):  
Case Report ◽  
American Heart Association ◽  
Orthodontic Treatment ◽  
American Heart ◽  
Working Party ◽  
Heart Association ◽  
Bacterial Endocarditis ◽  
British Society ◽  
Risk Patients ◽  
Orthodontic Patients

A case of acute bacterial endocarditis associated with orthodontic treatment is described and the problems associated with orthodontic treatment for ‘at risk’ patients are discussed. The American Heart Association recommendations for orthodontic patients are Summarized, and the general recommendations of the Endocarditis Working Party of the British Society for Antimicrobial Chemotherapy are appended.

Antibiotic prophylaxis for Dental Patients with Joint Prostheses? A Decision Analysis

1990 ◽  
Vol 6 (4) ◽  
pp. 569-587 ◽  
Author(s):  
Jed J Jacobson ◽  
Stuart Schweitzer ◽  
David J. DePorter ◽  
J. Jack Lee
Keyword(s):  
Decision Analysis ◽  
Antibiotic Prophylaxis ◽  
Joint Infection ◽  
Cost Effective ◽  
Preventive Strategy ◽  
Dental Patients ◽  
Risk Of Death ◽  
Oral Penicillin ◽  
Prosthetic Joint ◽  
Joint Prostheses

AbstractA decision analysis was performed to assess the risks, costs, and effects of no prophylaxis, oral penicillin, and cephalexin regimens currently being debated for dental patients at risk for late prosthetic joint infection (LPJI). The analysis suggests that there is a very small risk of LPJI (29.3 cases per 106 dental visits), which is outweighed by a greater risk of death with an oral penicillin strategy than with a “no prophylaxis” strategy (2.31:1.93). An oral cephalosporin appears to spare life and limb but does so at an extremely high cost. Over $500,000 must be spent to spare one year of life, while $480,000 needs to be spent to prevent one case of LPJI. Some individual dental patients may still be at a much greater risk for LPJI than others. However, from the evidence to date, routine predental antibiotic prophylaxis for all prosthetic joint patients is a very expensive preventive strategy and is not cost-effective. However, clinical experience suggests that antibiotic prophylaxis may be appropriate in some situations.

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