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Antibiotic prophylaxis in oral healthcare - the agreement between Swedish recommendations and evidence.

Ellervall, E; Vinge, Ellen LU ; Rohlin, M and Knutsson, Kerstin (2010) In British dental journal 208(3). p.5-115
Abstract
BACKGROUND: Almost all (17/20) Swedish counties have pharmaceutical committees that establish recommendations for the use of antibiotic prophylaxis in oral healthcare.Objective To evaluate the evidence for the use of antibiotic prophylaxis in oral healthcare and the agreement between Swedish recommendations and evidence. MATERIAL AND METHODS: We conducted a systematic literature search in PubMed and the Cochrane Controlled Trials Register. The MeSH terms 'antibiotic prophylaxis' and 'dentistry' were used in the database search. Abstracts were reviewed according to specific inclusion and exclusion criteria. A total of 186 articles were read in full text by the four authors independently. Data extraction and interpretation of data was... (More)
BACKGROUND: Almost all (17/20) Swedish counties have pharmaceutical committees that establish recommendations for the use of antibiotic prophylaxis in oral healthcare.Objective To evaluate the evidence for the use of antibiotic prophylaxis in oral healthcare and the agreement between Swedish recommendations and evidence. MATERIAL AND METHODS: We conducted a systematic literature search in PubMed and the Cochrane Controlled Trials Register. The MeSH terms 'antibiotic prophylaxis' and 'dentistry' were used in the database search. Abstracts were reviewed according to specific inclusion and exclusion criteria. A total of 186 articles were read in full text by the four authors independently. Data extraction and interpretation of data was carried out using a pre-defined protocol. In the end, one case-control study was included for evaluation of evidence. RESULTS: The case-control study included patients with specific cardiac conditions. The study reported a 49% protective efficacy (odds ratio: 0.51) of antibiotic prophylaxis for first-time episodes of endocarditis within 30 days of procedure. This result was not statistically significant. The quality of the evidence was low. No studies were evaluated on patients with other medical conditions. The recommendations included several cardiac and other medical conditions for which there is a lack of evidence or no evidence to support the use of antibiotic prophylaxis.CONCLUSIONS: There is a lack of evidence to support the use of antibiotic prophylaxis. To avoid the risk of adverse events from antibiotics and the risk of developing resistant bacterial strains, the use of antibiotic prophylaxis should be minimised and recommendations in Sweden should be revised to be more evidence-based. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British dental journal
volume
208
issue
3
pages
5 - 115
publisher
Nature Publishing Group
external identifiers
  • WOS:000274430200017
  • PMID:20134479
  • Scopus:77149153694
ISSN
1476-5373
DOI
10.1038/sj.bdj.2010.107
language
English
LU publication?
yes
id
70928618-9c06-4529-a655-5c4ac7c77e89 (old id 1552928)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20134479?dopt=Abstract
date added to LUP
2010-03-02 17:50:31
date last changed
2016-10-13 04:32:01
@misc{70928618-9c06-4529-a655-5c4ac7c77e89,
  abstract     = {BACKGROUND: Almost all (17/20) Swedish counties have pharmaceutical committees that establish recommendations for the use of antibiotic prophylaxis in oral healthcare.Objective To evaluate the evidence for the use of antibiotic prophylaxis in oral healthcare and the agreement between Swedish recommendations and evidence. MATERIAL AND METHODS: We conducted a systematic literature search in PubMed and the Cochrane Controlled Trials Register. The MeSH terms 'antibiotic prophylaxis' and 'dentistry' were used in the database search. Abstracts were reviewed according to specific inclusion and exclusion criteria. A total of 186 articles were read in full text by the four authors independently. Data extraction and interpretation of data was carried out using a pre-defined protocol. In the end, one case-control study was included for evaluation of evidence. RESULTS: The case-control study included patients with specific cardiac conditions. The study reported a 49% protective efficacy (odds ratio: 0.51) of antibiotic prophylaxis for first-time episodes of endocarditis within 30 days of procedure. This result was not statistically significant. The quality of the evidence was low. No studies were evaluated on patients with other medical conditions. The recommendations included several cardiac and other medical conditions for which there is a lack of evidence or no evidence to support the use of antibiotic prophylaxis.CONCLUSIONS: There is a lack of evidence to support the use of antibiotic prophylaxis. To avoid the risk of adverse events from antibiotics and the risk of developing resistant bacterial strains, the use of antibiotic prophylaxis should be minimised and recommendations in Sweden should be revised to be more evidence-based.},
  author       = {Ellervall, E and Vinge, Ellen and Rohlin, M and Knutsson, Kerstin},
  issn         = {1476-5373},
  language     = {eng},
  number       = {3},
  pages        = {5--115},
  publisher    = {ARRAY(0xd00c858)},
  series       = {British dental journal},
  title        = {Antibiotic prophylaxis in oral healthcare - the agreement between Swedish recommendations and evidence.},
  url          = {http://dx.doi.org/10.1038/sj.bdj.2010.107},
  volume       = {208},
  year         = {2010},
}