Rela Rathi, Sejao Aarti Vidyasindhu, Singh Ankita, Singh Prabhat Kumar, Kumar Mukesh, Gupta Shweta Kirti, Rangari Priyadarshini
Department of Oral Medicine and Radiology, Nalanda Medical College And Hospital, Patna, Bihar, India.
Department of Community Medicine, Dr. N.Y. Tasgaonkar Institute of Medical Science, Karjat, Raigad, Maharashtra, India.
J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1637-S1641. doi: 10.4103/jpbs.jpbs_394_21. Epub 2021 Nov 10.
Studies have reported that dental procedures may serve as a portal of entry for bacteria into the blood circulation, commonly termed as bacteremia which may inhabitate the heart and joints subjected to repair and replacement by prosthesis and may lead to complications in immunocompromised patients. Dental procedure may play a pivotal role in the development of infective endocarditis and infection around the prosthetic joint. Antibiotic use is suggested for all dental procedures requiring gingival manipulation or of the periapical region of teeth or mucosal incision in these patients.
The present study has been conducted to inspect the antibiotic prescribing practices of general dentists among 250 dental practitioners.
The study was conducted on 250 dental surgeons practicing in the urban Indian population of various parts of the country. A validated questionnaire was developed by a multidisciplinary dental and medical team and was circulated on the subject of the basic knowledge and awareness about antibiotic prophylaxis in susceptible patients. The data from the participants were collected, collated, and statistically analyzed.
The present study comprised 250 dental surgeons; 178 out of 250 were male, whereas 72 were female. Antibiotic prophylaxis guidelines were followed by 169 practitioners (67.60%), whereas 81 (32.40%) dentists did not follow any guidelines. Out of 169, 67 followed the American Academy of Orthopaedic Surgeons (AAOS) guidelines (39.64%), 58 followed American Heart Association (AHA) guidelines (34.30%), whereas 44 followed general physician's guidelines (26.03%). On screening the underlying conditions for which antibiotic cover was prescribed, it was shown that majority of the dental surgeons did the same for patients with cardiac valve repair or replacement (230; 92%), followed by infective endocarditis (212; 84.80%); organ transplant (212; 84.405); diabetes (189; 75.60%); prosthetic joint replacement (150; 60%); and congenital heart defect (110; 44%).
Patients should then be trained to perform meticulous oral hygiene and advised to schedule regular dental checkups to maintain optimal dental health. Dentists should use antibiotic prophylaxis in only conditions associated with a valid scientific basis and should follow the standard protocols recommended by the American Dental Association, AHA, or AAOS.
研究报告称，牙科手术可能成为细菌进入血液循环的入口，通常称为菌血症，这可能会侵袭接受假体修复和置换的心脏和关节，并可能导致免疫功能低下患者出现并发症。牙科手术可能在感染性心内膜炎和人工关节周围感染的发生中起关键作用。建议对所有需要进行牙龈操作、涉及牙齿根尖区域或黏膜切开的牙科手术的此类患者使用抗生素。
本研究旨在调查250名牙科从业者中普通牙医的抗生素处方习惯。
该研究针对在印度不同地区城市人口中执业的250名牙科外科医生进行。一个多学科的牙科和医学团队编制了一份经过验证的问卷，并就易感患者抗生素预防的基本知识和认识这一主题进行了分发。收集、整理并对参与者的数据进行了统计分析。
本研究包括250名牙科外科医生；250名中有178名男性，72名女性。169名从业者（67.60%）遵循抗生素预防指南，而81名（32.40%）牙医未遵循任何指南。在169名中，67名遵循美国矫形外科医师学会（AAOS）指南（39.64%），58名遵循美国心脏协会（AHA）指南（34.30%），而44名遵循普通内科医生的指南（26.03%）。在筛查开具抗生素覆盖的潜在疾病时，结果显示，大多数牙科外科医生对心脏瓣膜修复或置换患者（230名；92%）、感染性心内膜炎患者（212名；84.80%）、器官移植患者（212名；84.405%）、糖尿病患者（189名；75.60%）、人工关节置换患者（150名；60%）和先天性心脏缺陷患者（110名；44%）采取了同样的做法。
然后应培训患者进行细致的口腔卫生护理，并建议他们定期安排牙科检查以保持最佳口腔健康。牙医应仅在有有效科学依据的情况下使用抗生素预防，并应遵循美国牙科协会、AHA或AAOS推荐的标准方案。
