Teixeira Erica C, Warren John J, McKernan Susan C, McQuistan Michelle R, Qian Fang
Department of Operative Dentistry, The University of Iowa College of Dentistry, Iowa City, Iowa.
Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry, Iowa City, Iowa.
Spec Care Dentist. 2020 Mar;40(2):198-205. doi: 10.1111/scd.12450. Epub 2020 Jan 21.
With the increasing number of patients with prosthetic joints, recommendations for antibiotic prophylaxis (AP) prior to dental procedures to prevent prosthetic joint infections (PJI) have changed.
This survey evaluated dentists' AP practices for patients with prosthetic joints undergoing dental procedures and their familiarity with the American Dental Association Guidelines (ADA CPG) and American Academy of Orthopaedic Surgeons Appropriate Use Criteria (AAOS AUC). Dentists' attitudes about antibiotic resistance, medical-legal aspects, and adverse effects to using AP were examined. Dentists (n = 574) were familiar (51.2%) with ADA CPG and with the AAOS AUC (25.8%). Familiarity varied according to years since graduation. Female dentists (63.5%) were more likely to be very familiar with the ADA CPG than male dentists (49.5%). Overall, 65.4% of respondents believed that AP is not effective in the prevention of PJI, and 19.4% believed there is enough evidence to support AP. For a healthy patient, 28.9% of dentists would never recommend AP, 44.9% would recommend AP within the first two years since prosthetic joint replacement.
Dentists' recommendations for the use of AP varied depending on different factors, including health status of the patient, dental procedure, time elapsed since joint surgery, suggesting that adherence to the ADA CPG and AUC is still challenging.
随着人工关节置换患者数量的增加，关于牙科手术前预防人工关节感染（PJI）的抗生素预防（AP）的建议已经发生了变化。
本调查评估了为接受牙科手术的人工关节置换患者提供AP的牙科医生的做法，以及他们对美国牙科协会指南（ADA CPG）和美国矫形外科医师学会合理使用标准（AAOS AUC）的熟悉程度。研究还考察了牙科医生对抗生素耐药性、医疗法律方面以及使用AP的不良反应的态度。共有574名牙科医生，其中51.2%熟悉ADA CPG，25.8%熟悉AAOS AUC。熟悉程度因毕业年限而异。女性牙科医生（63.5%）比男性牙科医生（49.5%）更有可能非常熟悉ADA CPG。总体而言，65.4%的受访者认为AP对预防PJI无效，19.4%的受访者认为有足够证据支持使用AP。对于健康患者，28.9%的牙科医生从不推荐使用AP，44.9%的牙科医生会在人工关节置换后的头两年内推荐使用AP。
牙科医生对AP的使用建议因不同因素而异，包括患者的健康状况、牙科手术、关节手术后的时间，这表明遵循ADA CPG和AUC仍然具有挑战性。
