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健康患者的牙种植术中抗生素使用是否存在共识?

Is there a consensus on antibiotic usage for dental implant placement in healthy patients?

机构信息

School of Dentistry, The University of Western Australia, Perth, Western Australia, Australia.

Department of Anatomy, Physiology and Human Biology, International Research Collaborative, Oral Health and Equity, The University of Western Australia, Perth, Western Australia, Australia.

出版信息

Aust Dent J. 2018 Mar;63(1):25-33. doi: 10.1111/adj.12535. Epub 2017 Jul 25.

Abstract

This systematic review aimed to determine whether there is consensus for antibiotic prescription in healthy patients undergoing implant placement. A search of PubMed, Embase and Medline databases was conducted in January 2016 to find published journal articles on the use of antibiotics in implant placement, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were prospective human clinical trials investigating antibiotic usage during implant placement. Fifteen studies were deemed suitable. In 13 studies, no statistical difference was found between antibiotic use and the incidence of prosthetic failure, implant failure and early postoperative infections. These were rated as having low to high risk bias. Contrary results were reported in two studies, both of which were rated as having a high potential for bias. In conclusion, antibiotic use in healthy patients for the prophylaxis of surgical infection associated with dental implant placement does not appear to improve clinical outcomes. Practitioners should apply principles of antimicrobial stewardship and not use antibiotics as a routine measure in healthy patients.

摘要

这篇系统综述旨在确定在接受种植体植入的健康患者中,抗生素的使用是否存在共识。根据系统评价和荟萃分析的首选报告项目,于 2016 年 1 月对 PubMed、Embase 和 Medline 数据库进行了检索,以查找有关抗生素在种植体植入中使用的已发表期刊文章。纳入标准为前瞻性人类临床试验,研究了种植体植入过程中抗生素的使用。有 15 项研究被认为是合适的。在 13 项研究中,抗生素的使用与修复体失败、种植体失败和术后早期感染的发生率之间没有统计学差异。这些研究被评为低到高风险偏倚。两项研究报告了相反的结果,这两项研究都被评为存在高偏倚风险。总之,在健康患者中使用抗生素预防与牙种植体植入相关的手术感染似乎并不能改善临床结果。从业者应遵循抗菌药物管理原则,而不是将抗生素作为健康患者的常规措施使用。

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