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牙科医学与感染性心内膜炎:抗生素预防的现行指南及日常临床实践建议。

Dental Medicine and Infective Endocarditis: Current guidelines for antibiotic prophylaxis and recommendations for daily clinical practice.

作者信息

Schriber Martina, Sendi Parham, Greutmann Matthias, Bornstein Michael M

机构信息

Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel UZB und Universität Basel.

Klinik für Infektiologie und Abteilung für Spitalhygiene, Universitätsspital Basel und Universität Basel.

出版信息

Swiss Dent J. 2021 Mar 8;131(3):245-251. doi: 10.61872/sdj-2021-03-04.

Abstract

Surgical interventions in the dental practice as well as interventions in the ear, nose and throat area, the skin, the respiratory, gastrointestinal or urogenital tract can lead to transient bacteremia. As a result, an infectious endocarditis (IE) may occur. Overall, this is a rare occurrence, but it is associated with high morbidity and mortality. Individuals with a history of IE, implanted valve prostheses and certain congenital heart defects are at the highest risk for IE. In dental medicine, there is a controversial debate as to whether bacteremia can occur already by chewing or brushing the teeth. Antibiotic prophylaxis for prevention of endocarditis should only be given to those patients who are at the highest risk for IE. This article discusses novelties and Swiss recommendations for antibiotic prophylaxis for highrisk patients for IE in the dental practice. In this context, antibiotic prophylaxis has gained importance for dentists, which is also reflected by the fact that the recommendations on the new endocarditis card are limited solely to dental interventions.

摘要

牙科实践中的外科手术以及耳、鼻、喉区域、皮肤、呼吸道、胃肠道或泌尿生殖道的手术都可能导致短暂性菌血症。因此,可能会发生感染性心内膜炎(IE)。总体而言,这种情况很少见,但它与高发病率和死亡率相关。有IE病史、植入瓣膜假体和某些先天性心脏缺陷的个体患IE的风险最高。在牙科医学中,对于咀嚼或刷牙是否已经会导致菌血症存在争议性的辩论。预防心内膜炎的抗生素预防措施仅应给予那些患IE风险最高的患者。本文讨论了牙科实践中针对IE高危患者的抗生素预防的新情况和瑞士建议。在这种情况下,抗生素预防对牙医来说变得很重要,新的心内膜炎卡片上的建议仅局限于牙科干预这一事实也反映了这一点。

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