An international group of researchers and experts in the field of Oral Medicine, led by colleagues Giovanni Lodi, Pedro Diz Dios and Valeria Edefonti, recently published an important article in the journal JAMA Cardiology on antibiotic prophylaxis and the incidence of bacterial endocarditis after dental treatment.
The authors are part of the World Workshop on Oral Medicine VIII group made of researchers from various countries such as Italy (Giovanni Lodi; Valeria Edefonti; Margherita Gobbo; Federica Turati), Spain (Pedro Diz Dios), the United Kingdom (Martin Thornhill), South Africa (Haly Holmes), Singapore (C. Hong), Thailand (Pimolbutr), USA (Francesca Sperotto; Katherine France; Laurel Graham; Thomas Sollecito; Peter Lockhart) and Portugal represented by researcher and dentist, Luís Monteiro.
Luís Monteiro, an associate professor at CESPU, is currently director of the Oral Pathology and Oral Rehabilitation Research Unit (UNIPRO). UNIPRO’s participation in this work is the result of the objectives of multidisciplinarity, internationalization, and a commitment to scientific research with the production of research that can be applied in society to benefit the health of the population.
This is an important article on a very complicated subject where there has been a lack of scientific evidence on the need to use antibiotic prophylaxis before dental treatment, with different indications and even countries not suggesting the use of this type of prophylaxis. These concerns are related, on the one hand, to the possible existence of allergic reactions in some patients, the potential contribution to the increase in antibiotic resistance and, on the other, to the lack of scientific evidence for the use of this type of prophylaxis in the prevention of bacterial endocarditis after invasive dental procedures.
The authors therefore carried out a systematic review with meta-analysis of the existing literature to assess the association between antibiotic prophylaxis and the incidence of infective endocarditis following invasive dental procedures. The resulting study, which included data from 1,152,345 cases of infective endocarditis, concluded that antibiotic prophylaxis was associated with a reduced risk of infective endocarditis following invasive dental procedures in high-risk individuals, but not in those at moderate or low/unknown risk. In fact, high-risk individuals who received antibiotic prophylaxis before invasive dental procedures were 59% (95% CI, 43-71) less likely to develop infective endocarditis than those who did not receive antibiotic prophylaxis.
These results support the use of antibiotic prophylaxis only in high-risk individuals undergoing invasive dental procedures, supporting the current guidelines of the American Heart Association and the European Society of Cardiology.
Image by Steve Buissine, Pixabay
