Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
Department of Dentistry, MacKay Memorial Hospital, Taipei, Taiwan.
J Dent Res. 2019 Oct;98(11):1204-1210. doi: 10.1177/0022034519870466. Epub 2019 Aug 30.
Postdental procedure bacteremia is common and troublesome. The comparative efficacy of multiple prophylactic interventions is unclear. We compared the efficacy of interventions for the prevention of postdental procedure bacteremia. We conducted a review of ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov from inception to December 4, 2018. Randomized controlled trials that evaluated prophylactic interventions for the prevention of postdental procedure bacteremia were eligible. The primary outcome was the incidence of postdental procedure bacteremia. A total of 24 trials were included with 2,147 participants. Our network meta-analysis demonstrated that intravenous administration of 1,000/200 mg of amoxicillin/clavulanate provided the least incidence of postdental procedure bacteremia among all the prophylactic interventions (odds ratio = 0.03, 95% CI = 0.00 to 0.63) as compared with the placebo/controls. Oral 3 g of amoxicillin had the least incidence of postdental procedure bacteremia among all oral or topical forms of prophylactic interventions (odds ratio = 0.10, 95% CI = 0.02 to 0.44) as compared with the placebo/controls. No serious adverse events, such as anaphylactic shock, mortality, and the development of antibiotic-resistant bacteria, were reported. None of the included subjects were of high risk of infectious endocarditis. Our network meta-analysis demonstrates that intravenous amoxicillin/clavulanate and oral amoxicillin might be the best prophylactic interventions in preventing postdental procedure bacteremia among all the oral/topical forms of interventions for the overall populations.
牙后程序菌血症很常见且令人烦恼。多种预防干预措施的比较疗效尚不清楚。我们比较了预防牙后程序菌血症的干预措施的疗效。我们对 ClinicalKey、Cochrane CENTRAL、Embase、ProQuest、PubMed、ScienceDirect、Web of Science 和 ClinicalTrials.gov 进行了回顾，检索时间从建库至 2018 年 12 月 4 日。纳入评估预防牙后程序菌血症的预防干预措施的随机对照试验。主要结局是牙后程序菌血症的发生率。共有 24 项试验纳入 2147 名参与者。我们的网络荟萃分析表明，与安慰剂/对照组相比，静脉给予 1000/200mg 阿莫西林/克拉维酸的预防干预措施可使牙后程序菌血症的发生率最低（比值比=0.03，95%可信区间=0.00 至 0.63）。与安慰剂/对照组相比，所有口服或局部预防干预措施中，口服 3g 阿莫西林的牙后程序菌血症发生率最低（比值比=0.10，95%可信区间=0.02 至 0.44）。未报告严重不良事件，如过敏性休克、死亡率和抗生素耐药菌的发展。纳入的受试者均无感染性心内膜炎的高风险。我们的网络荟萃分析表明，与安慰剂/对照组相比，静脉给予阿莫西林/克拉维酸和口服阿莫西林可能是预防牙后程序菌血症的最佳预防干预措施，适用于所有口服/局部形式的干预措施的总体人群。
