School of Pharmacy, University of Wolverhampton, Wulfruna Street, Wolverhampton WV1 1LY, UK.
Medicina (Kaunas). 2023 Apr 5;59(4):713. doi: 10.3390/medicina59040713.
: This project was developed from anecdotal evidence of varied practices around antibiotic prescribing in dental procedures. The aim of the study was to ascertain if there is evidence to support whether antibiotic (AB) use can effectively reduce postoperative infections after dental implant placements (DIPs). : Following PRISMA-P© methodology, a systematic review of randomised controlled clinical trials was designed and registered on the PROSPERO© database. Searches were performed using PubMed, Science Direct and the Cochrane© Database, plus the bibliographies of studies identified. The efficacy of prophylactic antibiotics, independent of the regimen used, versus a placebo, control or no therapy based on implant failure due to infection was the primary measured outcome. Secondary outcomes were other post-surgical complications due to infection and AB adverse events. : Twelve RCTs were identified and analysed. Antibiotic use was reported to be statistically significant in preventing infection ( < 001). The prevention of complications was not statistically significant ( = 0.96), and the NNT was >5 (14 and 2523 respectively), which indicates that the intervention was not sufficiently effective to justify its use. The occurrence of side effects was not statistically significant ( = 0.63). NNH was 528 indicating that possible harm caused by the use of ABs is very small and does not negate the AB use when indicated. : The routine use of prophylactic antibiotics to prevent infection in dental implant placement was found to be not sufficiently effective to justify routine use. Clear clinical assessment pathways, such as those used for medical conditions, based on the patients' age, dental risk factors, such as oral health and bone health, physical risk factors, such as chronic or long-term conditions and modifiable health determinants, such as smoking, are required to prevent the unnecessary use of antibiotics.
: 本项目源自牙科操作中抗生素使用情况的各种做法的传闻证据。本研究旨在确定是否有证据支持使用抗生素（AB）是否能有效降低牙种植术后感染的发生率。: 本研究采用 PRISMA-P© 方法，设计并在 PROSPERO© 数据库中注册了一项随机对照临床试验的系统评价。使用 PubMed、Science Direct 和 Cochrane© 数据库进行了检索，并对已确定研究的参考文献进行了检索。主要测量结果是评估预防使用抗生素（无论使用何种方案）与安慰剂、对照组或无治疗相比，因感染导致种植体失败的疗效。次要结果是其他与感染相关的术后并发症和 AB 不良反应。: 共确定并分析了 12 项 RCT。抗生素的使用在预防感染方面具有统计学意义（<0.001）。预防并发症的效果无统计学意义（=0.96），NNT>5（分别为 14 和 2523），这表明该干预措施效果不够显著，不足以证明其使用的合理性。副作用的发生无统计学意义（=0.63）。NNH 为 528，表明 AB 使用可能造成的危害很小，不会否定 AB 在适应证时的使用。: 本研究发现，在牙种植术中常规使用预防性抗生素预防感染的效果不够显著，不足以证明其常规使用的合理性。需要建立明确的临床评估途径，例如针对患者年龄、口腔健康和骨骼健康等牙科危险因素、慢性或长期疾病等身体危险因素以及吸烟等可改变的健康决定因素，来预防不必要的抗生素使用。
