Antibiotic prophylaxis for endocarditis: time to reconsider

Singh, J., Straznicky, I., Avent, M. and Goss, A. N. (2005) Antibiotic prophylaxis for endocarditis: time to reconsider. Australian Dental Journal, 50 4: S60-S68. doi:10.1111/j.1834-7819.2005.tb00388.x

Author Singh, J.
Straznicky, I.
Avent, M.
Goss, A. N.
Title Antibiotic prophylaxis for endocarditis: time to reconsider
Journal name Australian Dental Journal   Check publisher's open access policy
ISSN 0045-0421
Publication date 2005-12-01
Sub-type Article (original research)
DOI 10.1111/j.1834-7819.2005.tb00388.x
Open Access Status Not Open Access
Volume 50
Issue 4
Start page S60
End page S68
Total pages 9
Place of publication Chichester, West Sussex United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Abstract Some cardiac conditions require antibiotic prophylaxis for some types of dental treatment to reduce the risk of infective endocarditis (IE). All medical and dental practitioners are familiar with this practice but tend to use different regimens in apparently similar circumstances. Generally, the trend has been to prescribe antibiotics if in doubt. This review explores the evidence for antibiotic prophylaxis to prevent IE: does it work and is it safe? The changing nature of IE, the role of bacteraemia of oral origin and the safety of antibiotics are also reviewed. Most developed countries have national guidelines and their points of similarity and difference are discussed. One can only agree with the authority who describes antibiotic guidelines for endocarditis as being ‘like the Dead Sea Scrolls, they are fragmentary, imperfect, capable of various interpretations and (mainly) missing!’ Clinical case-controlled studies show that the more widely antibiotics are used, the greater the risk of adverse reactions exceeding the risk of IE. However, the consensus is that antibiotic prophylaxis is mandatory for a small number of high-risk cardiac and high-risk dental procedures. There are a large number of low-risk cardiac and dental procedures in which the risk of adverse reactions to the antibiotics exceeds the risk of IE, where prophylaxis should not be provided. There is an intermediate group of cardiac and dental procedures for which careful individual evaluation should be made to determine whether IE or antibiotics pose the greater risk. These categories are presented. All medical and dental practitioners need to reconsider their approach in light of these current findings.
Keyword Antibiotic prophylaxis
Dental treatment
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
School of Public Health Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 13 times in Thomson Reuters Web of Science Article | Citations
Google Scholar Search Google Scholar
Created: Mon, 23 Feb 2015, 20:31:48 EST by Ms Kate Rowe on behalf of School of Public Health