Homaj Magdalena, Szotek Michał, Sabatowski Karol, Zabojszcz Michał, Loster Bartłomiej W, Sadowski Marcin, Siudak Zbigniew
Private Dental Practice Stomatologia-Beliny, Kraków, Poland.
2nd Department of Cardiology and Cardiovascular Interventions, University Hospital in Kraków, Poland.
Folia Med Cracov. 2019;59(4):5-12. doi: 10.24425/fmc.2019.131375.
Infective endocarditis (IE) is a potentially life-threatening condition. According to current ESC (European Society of Cardiology) guidelines, the use of antibiotic prophylaxis should only be reserved for specific dental procedures with interruption of consistency of the oral mucosa such as extractions and should be reserved for patients with the highest risk of developing IE. The aim of this study was to assess the knowledge of need for IE prophylaxis in de ned clinical settings among Polish dentists.
A specially self-designed internet questionnaire was created concerning the topic of infective endocarditis prophylaxis in specific clinical scenarios for patients undergoing dental extractions during outpatient visits. The survey was made available to the dentists via internet and was active in March 2018.
there were 352 Polish dentists who completed the survey. Antibiotic prophylaxis for IE during dental extractions was used in 93% of cases with prior IE, 89% with artificial heart valve, 69% with biological valve, 28% with pacemaker, 54% with coronary stent, 73% with cyanotic heart defect, 58% with diabetes mellitus, 20% after prior myocardial infarction and 54% with heart valve disease. There was a significant relationship between the time of working as a physician (>15 years) and more outdated or improper IE prophylaxis (p = 0.04).
the management of patients for infective endocarditis prophylaxis undergoing dental extractions is suboptimal. Antibiotic therapy is overused in some clinical scenarios and on the other hand underutilized in those recommended by the current ESC guidelines.
感染性心内膜炎（IE）是一种潜在的危及生命的疾病。根据欧洲心脏病学会（ESC）目前的指南，抗生素预防仅应保留用于特定的牙科手术，如拔牙等会中断口腔黏膜完整性的手术，且仅适用于发生IE风险最高的患者。本研究的目的是评估波兰牙医在特定临床环境中对IE预防必要性的认识。
针对门诊拔牙患者在特定临床场景下的IE预防主题，设计了一份专门的网络问卷。该调查通过互联网向牙医提供，并于2018年3月开展。
有352名波兰牙医完成了调查。在有既往IE病史的患者中，93%的病例在拔牙时使用了IE抗生素预防；人工心脏瓣膜患者中为89%；生物瓣膜患者中为69%；起搏器患者中为28%；冠状动脉支架患者中为54%；青紫型心脏缺陷患者中为73%；糖尿病患者中为58%；既往心肌梗死后患者中为20%；心脏瓣膜病患者中为54%。医生工作时间（>15年）与更过时或不恰当的IE预防之间存在显著关联（p = 0.04）。
对拔牙患者进行感染性心内膜炎预防的管理并不理想。在某些临床场景中抗生素治疗被过度使用，而在当前ESC指南推荐的场景中却未得到充分利用。
