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牙科诱发的人工关节感染的误区。

Myths of dental-induced prosthetic joint infections.

作者信息

Wahl M J

机构信息

Medical Center of Delaware, Wilmington, USA.

出版信息

Clin Infect Dis. 1995 May;20(5):1420-5. doi: 10.1093/clinids/20.5.1420.

Abstract

The overwhelming majority of orthopedists and dentists surveyed recommend antibiotic prophylaxis for dental procedures to prevent late prosthetic joint infection. It is time to stop this practice, which is not based on scientific evidence but rather on "myths" of prosthetic joint infections after dental procedures. The first myth is that there are close similarities between late prosthetic valve endocarditis and late prosthetic joint infection. The second myth is that dental treatment is the probable cause of a large percentage of prosthetic joint infections. The third myth is that results of animal experiments have shown that transient bacteremia due to dental procedures can cause prosthetic joint infections in humans. The fourth myth is that the benefits of antibiotic prophylaxis for patients with prosthetic joints outweigh the risks and costs. The fifth and final myth is that clinicians should recommend antibiotic prophylaxis before dental treatment for patients with prosthetic joints to protect themselves legally.

摘要

绝大多数接受调查的骨科医生和牙医都建议在进行牙科手术时使用抗生素预防措施,以防止晚期人工关节感染。是时候停止这种做法了,因为它并非基于科学证据,而是基于牙科手术后人工关节感染的“神话”。第一个神话是晚期人工瓣膜心内膜炎和晚期人工关节感染之间有密切相似之处。第二个神话是牙科治疗可能是很大一部分人工关节感染的原因。第三个神话是动物实验结果表明,牙科手术引起的短暂菌血症可导致人类人工关节感染。第四个神话是人工关节患者使用抗生素预防的益处大于风险和成本。第五个也是最后一个神话是临床医生应该在为人工关节患者进行牙科治疗前推荐抗生素预防措施,以保护自己免受法律诉讼。

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