Quality appraisal of antibiotic prophylaxis guidelines to prevent infective endocarditis following dental procedures: a systematic review

 Published:July 24, 2022DOI:https://doi.org/10.1016/j.oooo.2022.07.012

Abstract

Objective

: To assess the quality of clinical practice guidelines for the use of antimicrobial prophylaxis to prevent infective endocarditis in indicated dental procedures.

Study design

: We searched on Medline/OVID, CINAHL/EBSCO, EMBASE from January 2011 to January 2022. We included de novoguidelines and excluded adapted or adopted guidelines, and guidelines published before 2011. Guidelines were independently appraised by four reviewers using the Appraisal of Guidelines for Research & Evaluation (AGREE II) Instrument.

Results

: Four eligible clinical practice guidelines (CPGs) were appraised: The European Society of Cardiology (ESC), the American Heart Association (AHA), the National Institute of Health and Care Excellence (NICE), and the Japanese Circulation Society (JCS). Their AGREE II first overall assessments (OA1) were 63%, 58%, 92%, and 71% respectively. NICE and JCS scored the highest in OA1 (greater than 70%), Domain [3] Rigor of Development (85%, 65%), and domain [5] Applicability (76%, 48%), respectively. The second overall assessment (OA2) of using the CPGs in daily practice was not significantly variable (recommended for use with modifications).

Conclusion

: three out of four CPGs support that the benefits of prevention of infective endocarditis outweigh the risks of antibiotic resistance.