DT News - UK - Study supports use of preventative antibiotic use in high-risk patients

Dental Tribune International

Fri. 9 November 2018

save

SHEFFIELD, UK: Currently, the National Institute for Health and Care Excellence (NICE) guidelines recommend that dentists should generally not use antibiotic prophylaxis against infective endocarditis (IE) for patients undergoing invasive dental treatment. A new study of the American Heart Association (AHA) guidelines on this topic, however, has found that high-risk patients may benefit from continuing to receive this preventative therapy before treatment.

The study is the largest and most comprehensive research into the AHA’s 2007 recommendations that antibiotic prophylaxis should be given to patients at a high risk of developing IE, but not to those with a moderate risk. The findings showed that there had been a resultant 64 per cent decrease in antibiotic prescription for those at a moderate risk by 2015, though also a 20 per cent decrease for patients at a high risk. An estimated increase of 177 per cent in IE incidence in high-risk patients was subsequently noted.

“Although the data do not prove a cause–effect relationship between antibiotic prophylaxis reduction and IE increase, they are very supportive of the AHA recommendation to give antibiotic prophylaxis to those at high-risk but not to those at moderate-risk of endocarditis,” said lead author Prof. Martin Thornhill of the University of Sheffield’s School of Clinical Dentistry. “It also provides further evidence that the 2008 NICE recommendation that AP should cease completely in the UK was probably wrong and should be changed.”

“In the absence of clear and sensible advice from NICE, the recent attempt by the Scottish Dental Clinical Effectiveness Programme to provide advice for dentists about how to implement the NICE guidelines—effectively suggesting they follow the AHA recommendations—is very welcome,” he continued.

In 2015, Thornhill led a team at the University of Sheffield that identified that changes to the NICE guidelines in 2008 had led to an 89 per cent fall in preventative antibiotic prescription in the UK and an accompanying increase in cases of IE.

This new study provides further evidence to support the advice given by the AHA, and most other guideline committees around the world, that those at high-risk of IE undergoing invasive dental procedures should receive preventative antibiotic treatment.

The study, titled “Antibiotic prophylaxis and incidence of endocarditis before and after the 2007 AHA recommendations”, was published online in the Journal of the American College of Cardiology on 5 November 2018 ahead of inclusion in an issue. The findings will also be presented by Prof. Patrick O’Gara, Watkins Family Distinguished Chair in Cardiology at the Brigham and Women’s Hospital in Boston in the US, at the AHA Scientific Sessions in Chicago in the US on 11 November.

Tags:

One thought on “Study supports use of preventative antibiotic use in high-risk patients”

Peer Nelz says:

August 29, 2019 at 9:17 am

I never understood the change of NICE regulations in the first place!

To post a reply please login or register

SDCEP provides guidance for preventative antibiotic use

LONDON, UK: In 2016, the National Institute for Health and Care Excellence’s CG64 clinical guideline (NICE CG64) was revised to include new guidance for ...

Dental patients offered HIV tests over fears of contaminated equipment use

HODDESDON, UK: More than 500 patients at a Hoddesdon dental practice have been advised to take blood tests over concerns that the possible use of improperly...

Regular use of mouthrinse reduces caries in children

LONDON, UK: In order to determine the effectiveness and safety of fluoride mouthrinses in preventing dental caries in the younger population, researchers ...

New study examines antibiotic resistance in mouth microbiome

LONDON, UK: Antimicrobial resistance (AMR) influences the success of medical treatment and allows for unhindered diffusion of bacteria. Although antibiotic ...

Webinar to discuss use of images in biofilm control

Motivating patients to implement optimal oral hygiene at home is not an easy task. In a free Curaden webinar on Tuesday, 28 January, dental hygienist and ...

BSDHT extends support for antibiotic awareness initiative

BELFAST, UK: This Friday is European Antibiotic Awareness Day. On this occasion, the British Society of Dental Hygiene and Therapy (BSDHT) has announced it ...

New study examines extent of occupational risk of COVID-19 in UK

BIRMINGHAM, UK: To fill a research gap, researchers have recently examined whether dental professionals are, in fact, at an increased risk of becoming ...

Rise in endocarditis despite antibiotics guidelines for dentists

SHEFFIELD, UK: Scientists at the University of Sheffield have identified a significant rise in the number of people diagnosed with a serious heart infection...

Prescriptions of antibiotics in dentistry decrease

LONDON, UK: In line with general medical practices and hospitals, dental practices in the UK for the first time prescribed fewer antibiotics last year. ...

Emotional rollercoaster: Study examines tooth loss and removable denture use

SHEFFIELD, UK: In a first-of-its-kind study, researchers from the University of Sheffield have investigated patients’ emotional challenges in being ...

Education

On-demand
webinar