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Antibiotic prophylaxis is not indicated prior to dental procedures for prevention of periprosthetic joint infections
Acta orthop ; 88(5)Oct. 2017. ilus, tab
Article in English | BIGG - GRADE guidelines | ID: biblio-947867
Responsible library: BR1.1
ABSTRACT
Background and

purpose:

To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015. Studies were included if they involved patients with joint implants undergoing dental procedures, and either considered HPJI as an outcome measure or described a correlation between HPJI and prophylactic antibiotics. A guideline was formulated using the GRADE method and AGREE II guidelines. Results - 9 studies were included in this systematic review. All were rated "very low quality of evidence". Additional literature was therefore consulted to address clinical questions that provide further insight into pathophysiology and risk factors. The 9 studies did not provide evidence that use of antibiotic prophylaxis reduces the incidence of dental HPJI, and the additional literature supported the conclusion that antibiotic prophylaxis should be discouraged in dental procedures. Interpretation - Prophylactic antibiotics in order to prevent dental HPJI should not be prescribed to patients with a normal or an impaired immune system function. Patients are recommended to maintain good oral hygiene and visit the dentist regularly
Subject(s)
Full text: Available Collection: Tematic databases Health context: Sustainable Health Agenda for the Americas Health problem: Goal 10: Communicable diseases Database: BIGG - GRADE guidelines Main subject: Oral Hygiene / Prosthesis-Related Infections / Antibiotic Prophylaxis / Focal Infection, Dental / Joint Prosthesis / Anti-Bacterial Agents Type of study: Controlled clinical trial / Practice guideline / Observational study / Risk factors / Systematic review Language: English Journal: Acta orthop Year: 2017 Document type: Article
Full text: Available Collection: Tematic databases Health context: Sustainable Health Agenda for the Americas Health problem: Goal 10: Communicable diseases Database: BIGG - GRADE guidelines Main subject: Oral Hygiene / Prosthesis-Related Infections / Antibiotic Prophylaxis / Focal Infection, Dental / Joint Prosthesis / Anti-Bacterial Agents Type of study: Controlled clinical trial / Practice guideline / Observational study / Risk factors / Systematic review Language: English Journal: Acta orthop Year: 2017 Document type: Article
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