Peter Jens-Uwe, Ladewig Johannes, Stoll Christian, Zolk Oliver
Institute of Clinical Pharmacology, Immanuel Hospital Rüdersdorf, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany.
Department of Oral, Craniomaxillofacial and Plastic Surgery, Faculty of Medicine, University Hospital Ruppin-Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.
Int J Implant Dent. 2024 Dec 16;10(1):62. doi: 10.1186/s40729-024-00577-4.
Prophylactic antibiotics are used in dental implants to reduce infection risk and implant failure, especially benefiting patients with risk factors. However, evidence suggests that using clindamycin or extending antibiotics postoperatively has an unfavorable risk-benefit ratio.
This national cross-sectional study analyzed antibiotic prophylaxis during implant insertion across Germany. Dentists from the German Society for Oral Implantology (DGOI) provided demographic information and data on the next 10 consecutive implant patients, including age, sex, risk factors, type of implantation, and antibiotic details.
103 dentists participated, providing data on 1040 patients. Most dentists were male and aged 30-64. Patients were evenly split between genders, with an average age of 51 years. Antibiotics were administered in 87.6% of all cases, more frequently for patients undergoing bone augmentation (OR 7.01, p < 0.0001), immediate (OR 3.11, p = 0.002) or delayed (OR 5.30, p < 0.0001) implant insertion, and those with cardiovascular disease (OR 3.24, p = 0.009). 74.8% of implantologists tended to use antibiotic prophylaxis routinely, while the remaining implantologists decided on a case-by-case basis. Implantologists primarily used aminopenicillins for 63.8% of prescriptions and clindamycin for the remaining 35.6%. Additionally, 78.8% of patients with prophylaxis received postoperative, multi-day treatments.
The study reveals extensive antibiotic use for perioperative prophylaxis in implant surgery, often not justified by current recommendations, particularly concerning the choice of antibiotic (e.g., clindamycin) and duration (e.g., postoperative use). Specialized clinical guidelines and targeted training for dentists on antibiotic prophylaxis are needed.
牙科植入手术中使用预防性抗生素以降低感染风险和植入失败率，这对有风险因素的患者尤其有益。然而，有证据表明，使用克林霉素或术后延长抗生素使用时间的风险效益比不佳。
这项全国性横断面研究分析了德国各地植入手术期间的抗生素预防情况。德国口腔种植学会（DGOI）的牙医提供了接下来连续10例植入患者的人口统计学信息和数据，包括年龄、性别、风险因素、植入类型和抗生素详细信息。
103名牙医参与，提供了1040例患者的数据。大多数牙医为男性，年龄在30 - 64岁之间。患者性别分布均匀，平均年龄为51岁。所有病例中87.6%使用了抗生素，在进行骨增量手术的患者中更频繁使用（比值比7.01，p < 0.0001），即刻（比值比3.11，p = 0.002）或延迟（比值比5.30，p < 0.0001）植入手术的患者，以及患有心血管疾病的患者（比值比3.24，p = 0.009）。74.8%的种植医生倾向于常规使用抗生素预防，而其余种植医生则根据具体情况决定。种植医生开出的处方中，63.8%主要使用氨基青霉素，其余35.6%使用克林霉素。此外，78.8%接受预防治疗的患者术后接受了多天治疗。
该研究揭示了植入手术围手术期预防中广泛使用抗生素的情况，这通常不符合当前建议，特别是在抗生素选择（如克林霉素）和使用时长（如术后使用）方面。需要针对牙医制定专门的临床指南和关于抗生素预防的针对性培训。
