A Dental Blog With The Latest Dental News & Dental Technology For Your Dental Practice.
Monday, January 19, 2015
The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners-a report of the American Dental Association Council on Scientific Affairs.
J Am Dent Assoc. 2015 Jan;146(1):11-16.e8. doi: 10.1016/j.adaj.2014.11.012. Epub 2014 Dec 18.
panel of experts (the 2014 Panel) convened by the American Dental
Association Council on Scientific Affairs developed an evidence-based
clinical practice guideline (CPG) on the use of prophylactic antibiotics
in patients with prosthetic joints who are undergoing dental
procedures. This CPG is intended to clarify the "Prevention of
Orthopaedic Implant Infection in Patients Undergoing Dental Procedures:
Evidence-based Guideline and Evidence Report," which was developed and
published by the American Academy of Orthopaedic Surgeons and the
American Dental Association (the 2012 Panel).
TYPES OF STUDIES REVIEWED:
2014 Panel based the current CPG on literature search results and
direct evidence contained in the comprehensive systematic review
published by the 2012 Panel, as well as the results from an updated
literature search. The 2014 Panel identified 4 case-control studies.
2014 Panel judged that the current best evidence failed to demonstrate
an association between dental procedures and prosthetic joint infection
(PJI). The 2014 Panel also presented information about antibiotic
resistance, adverse drug reactions, and costs associated with
prescribing antibiotics for PJI prophylaxis.
PRACTICAL IMPLICATIONS AND CONCLUSIONS:
2014 Panel made the following clinical recommendation: In general, for
patients with prosthetic joint implants, prophylactic antibiotics are
not recommended prior to dental procedures to prevent prosthetic joint
infection. The practitioner and patient should consider possible
clinical circumstances that may suggest the presence of a significant
medical risk in providing dental care without antibiotic prophylaxis, as
well as the known risks of frequent or widespread antibiotic use. As
part of the evidence-based approach to care, this clinical
recommendation should be integrated with the practitioner's professional
judgment and the patient's needs and preferences.