Nomura Ryota, Kokomoto Kazuma, Ohara Takahiro, Nakatani Satoshi, Ooshima Takashi, Nakano Kazuhiko
Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan.
Division of Community Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Odontology. 2018 Jul;106(3):297-305. doi: 10.1007/s10266-018-0344-7. Epub 2018 Feb 12.
Infective endocarditis (IE), a life-threatening condition predominantly occurring in patients with underlying heart disease, is mainly caused by bacteremia induced by invasive dental treatment. However, the amount of related information shared between cardiologists and dentists appears to be inadequate. In the present study, a survey regarding prevention of IE, composed of 13 major questions, 2 of which also allowed free comments, was sent to approximately 3000 dentists belonging to a prefectural dental association in Japan. Of the 13.6% who returned the forms, more than 80% were general dentists with more than 20 years of experience. Approximately, 55% of the responders reported that they had opportunities to prescribe antibiotics prior to performing treatments with risk of IE, though noted difficulties with designation of which patients with heart disease were at risk. Most of the dentists considered that oral surgery procedures have a high risk for IE, whereas less invasive procedures were considered to be not associated with the disease. Approximately, 35% selected oral amoxicillin, with a dose of 2.0 g (20%) or 500 mg (27%) prescribed for adults, and 50 mg (10%) or 30 mg (12%) per kg of body weight for children. However, the timing of the antibiotics administration varied. The present results reveal current knowledge regarding prevention of IE among general dentists in Japan, and should be valuable for construction of a protocol to establish consensus between dentists and cardiologists.
感染性心内膜炎(IE)是一种主要发生在有基础心脏病患者中的危及生命的疾病,主要由侵入性牙科治疗引起的菌血症所致。然而,心脏病专家和牙医之间共享的相关信息似乎并不充分。在本研究中,一项关于IE预防的调查被发送给了日本一个县牙科协会的约3000名牙医,该调查由13个主要问题组成,其中2个问题还允许自由评论。在回复问卷的13.6%的人中,超过80%是有20多年经验的普通牙医。大约55%的受访者报告说,他们有机会在进行有IE风险的治疗前开抗生素,尽管指出在确定哪些心脏病患者有风险方面存在困难。大多数牙医认为口腔外科手术有很高的IE风险,而侵入性较小的手术则被认为与该病无关。大约35%的人选择口服阿莫西林,为成人开的剂量为2.0克(20%)或500毫克(27%),儿童为每公斤体重50毫克(10%)或30毫克(12%)。然而,抗生素给药的时间各不相同。目前的结果揭示了日本普通牙医对IE预防的现有认识,对于制定牙医和心脏病专家之间达成共识的方案应该是有价值的。