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口腔手术后发生菌血症:综述。

Bacteremia Associated With Oral Surgery: A Review.

机构信息

Oral Health and Masticatory System Group, Section of Oral Pathology, School of Dentistry, University of Barcelona, Barcelona, Spain.

Oral Health and Masticatory System Group, Section of Oral Pathology, School of Dentistry, University of Barcelona, Barcelona, Spain.

出版信息

J Evid Based Dent Pract. 2017 Sep;17(3):190-204. doi: 10.1016/j.jebdp.2016.12.001. Epub 2016 Dec 11.

Abstract

OBJECTIVES

Bacterial (infective) endocarditis, a microbial infection of the endocardium surfaces after bacteremia, causes significant morbidity and mortality. Recent epidemiologic studies have reported a prevalence of 2-8 cases per 100,000 individuals per year, with the highest incidence in those aged 70-80 years and those living in developed countries. We systematically reviewed the literature on several critical aspects regarding the development of bacteremia after oral surgery. The purpose of this work is to assess the controversy regarding antibiotic prophylaxis before oral surgery.

MATERIALS AND METHODS

Publications between 1976 and 2015 were included. Clinical studies focusing on oral surgery as the underlying cause were included.

RESULTS

Among the 32 clinical studies reviewed, 3564 cases, accounting for 12,839 blood cultures, were evaluated. In 10 of these studies, amoxicillin usefulness was studied. Antimicrobial prophylaxis before an invasive dental procedure does not prevent bacteremia, although it can decrease both its magnitude and its persistence.

CONCLUSIONS

The highly conflicting data and conclusions of the analyzed work highlight the need for new approaches to the study of bacteremia that would provide reliable evidence and thus appropriate prophylactic and therapeutic standards. Many reports have explored the occurrence of bacteremia after dental procedures, but the results have been conflicting.

摘要

目的

细菌性(感染性)心内膜炎是菌血症后心内膜表面的微生物感染,可导致严重的发病率和死亡率。最近的流行病学研究报告称,每年每 10 万人中有 2-8 例,发病率最高的是 70-80 岁的人群和发达国家的人群。我们系统地回顾了关于口腔手术后菌血症发生的几个关键方面的文献。本研究旨在评估口腔手术前预防性使用抗生素的争议。

材料和方法

纳入了 1976 年至 2015 年期间的出版物。纳入了专注于口腔手术作为潜在病因的临床研究。

结果

在 32 项临床研究中,共评估了 3564 例病例,共进行了 12839 次血培养。其中 10 项研究评估了阿莫西林的作用。侵袭性牙科手术前预防性使用抗生素不能预防菌血症,尽管它可以减少菌血症的严重程度和持续时间。

结论

分析工作得出的高度矛盾的数据和结论突出表明,需要采用新的方法来研究菌血症,从而提供可靠的证据,并制定适当的预防和治疗标准。许多报告已经探讨了牙科手术后菌血症的发生,但结果存在争议。

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