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Evidence summaries

Antibiotics for the Prophylaxis of Bacterial Endocarditis in Dentistry

There is insufficient evidence whether antibiotic prophylaxis is either effective or ineffective against bacterial endocarditis after an invasive dental procedure. Level of evidence: "D"

A Cochrane review [Abstract] 1 included one case-control study. It collected all the cases of endocarditis in the Netherlands over 2 years, finding a total of 24 people who developed endocarditis within 180 days of an invasive dental procedure, definitely requiring prophylaxis according to current guidelines and who were at increased risk of endocarditis due to a pre-existing cardiac problem. This study included participants who died because of the endocarditis (using proxys). Controls attended local cardiology outpatient clinics for similar cardiac problems, had undergone an invasive dental procedure within the past 180 days and were matched by age with the cases. No significant effect of penicillin prophylaxis on the incidence of endocarditis could be seen. No data were found on other outcomes.

References

  • Rutherford SJ, Glenny AM, Roberts G et al. Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures. Cochrane Database Syst Rev 2022;(5):CD003813. [PubMed]

Primary/Secondary Keywords