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Analysis Examines Prophylactic Antibiotics for Patients at Risk For Infective Endocarditis

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imaging
Vegetation of infective endocarditis on tricuspid valve by echocardiography.
PHOTO COURTESY OF: DAISUKE KOYA, KAZUYUKI SHIBUYA, RYUICHI KIKKAWA AND MASAKAZU HANEDA

Sweden is one of the few countries that has rescinded the recommendation to prescribe prophylactic antibiotics to dental patients at high risk for infective endocarditis. Now, a large-scale study has found that since the guidance was removed in 2012, there has been no increase in this disease.

Infective endocarditis is a life-threatening condition caused by bacterial infection of the heart valves. Previously, Swedish patients at high risk for infective endocarditis received amoxicillin as a prophylactic measure before extractions or oral surgery. The recommendation was lifted, however, due to a lack of evidence this was necessary.

Reporting in “Infective Endocarditis Among High-Risk Individuals — Before and After the Cessation of Antibiotic Prophylaxis in Dentistry: A National Cohort Study,” published in Clinical Infectious Diseases, the authors note only “small, statistically nonsignificant variations in morbidity” — data which they say support the change in recommendation.

The study — which monitored subjects from 2008 to 2018 — involved 76,762 high-risk individuals and 396,048 patients at low risk for infective endocarditis. The researchers note their analysis may help officials in other countries consider modifying guidance in this area, as this would limit antibiotic use and help address global concerns about the ongoing threat of antibiotic resistance.

From Decisions in Dentistry. June 2022;8(6)8.

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