Rahman Naomi, Rogers Seamus, Ryan David, Healy Claire, Flint Stephen
Department of Oral & Maxillofacial Surgery & Oral Medicine, Dublin Dental School & Hospital.
J Ir Dent Assoc. 2008;54(6):264-70.
The latest guidelines from the American Heart Association (AHA) 2007, the Journal of the American Dental Association (JADA) 2008, the Australian Prevention of Endocarditis Guidelines 2008, the British Society for Antimicrobial Chemotherapy (BSAC) 2006, and the National Institute for Clinical Excellence (NICE) 2008 were reviewed for this article. As a result of recent literature reviews by the AHA and NICE committees, both groups made recommendations regarding antibiotic prophylaxis for dental treatment. While both agree that the benefit of prophylaxis for dental treatment is unproven, the NICE committee has recommended no antibiotic cover for any patients previously classified as 'at risk' of infective endocarditis (IE), while the AHA has recommended cover only for patients deemed to be at high risk of developing IE and with the poorest outcome in the event of IE development. The BSAC guidelines and the recently published Australian Therapeutic Guidelines on Prevention of Endocarditis 2008 fall broadly into line with the AHA guidelines. This paper will review all the separate guidelines and advocate a regimen for treating at-risk patients.
为撰写本文，对美国心脏协会（AHA）2007年、美国牙科协会杂志（JADA）2008年、澳大利亚2008年感染性心内膜炎预防指南、英国抗菌化疗协会（BSAC）2006年以及英国国家临床优化研究所（NICE）2008年发布的最新指南进行了回顾。由于AHA和NICE委员会近期进行的文献综述，这两个组织都就牙科治疗的抗生素预防提出了建议。尽管双方都认为牙科治疗预防的益处尚未得到证实，但NICE委员会建议，对于之前被归类为感染性心内膜炎（IE）“高危”的任何患者，都不给予抗生素预防，而AHA则建议仅对被认为发生IE风险高且一旦发生IE预后最差的患者给予预防。BSAC指南以及最近发布的澳大利亚2008年预防感染性心内膜炎治疗指南在很大程度上与AHA指南一致。本文将回顾所有这些单独的指南，并倡导一种针对高危患者的治疗方案。
