Meidam, F. (Fauve) (2013) Retrospectief cohort onderzoek naar de toepassing van endocarditis profylaxe door Nederlandse tandartsen. thesis, Dentistry.
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Abstract
Objectives Bacterial endocarditis, an infection of the endocard and the heartvalves is caused by grampositive bacteria, especially by streptococci, enterococci en Staphylococcus aureus. The oral area is mostly seen as the source of the bacteraemia by literature. That's the reason why endocarditisprophylaxis is indicated previous to an invasive dental treatment in patients at risk for developing a bacterial endocarditis. There has changed a lot recently in the policy and there has been developed a new guideline in which the indications are narrowed. But has it already changed in the dental practice? The purpose of this study is to fmd out if patients who have had an endocarditis have been given a prophylaxis correctly previous to dental treatment. Do dentists keep themselves to the guideline? Or do they choose to keep themselves to the previous protocol with a broad indication area. A second goal is to fmd out if the right prophylaxis has been given and in which treatment there has been indicated. Materials and methods This study is a retrospective cohort study. The parameters used in this study are the percentage of dentists who have indicated a prophylaxis, the incidence of bacterial endocarditis, de indications in which prophylaxis has been given and the type of prophylaxis given to patients. A database is developed with patients who have been diagnosed with a bacterial endocarditis after 2009 following to the Duke's criteria. The data from the dental records have been analysed and put into charts. Results In 12% of all cases dentist indicate a prophylaxis more often then strictly neccesary following the guideline. In 37,8% of all cases there has been made an indication for a not invasive treatment. These are supragingival cleaning, restaurations or with every dental appointment. Amoxicilline is used as a first choise of antibiotics in most cases, clindamicine is used as a good alternative. Notable is that in 13,5% of all cases the antimicrobial mouthrinse corsodyl ( chlorhexidin 0,2%) is used previous to dental treatment and afterwards as well. This is used in addition to antibiotics to prevent bacteraemia and is used in every dental appointment .. Conclusion Dentist make use of a broader indication area than strictly necessary and even in treatments which are not invasive. They indicate broader than prescribed by the most recent guideline. The use of corsodyl is not scientificly verified. There is a theoretical effect, but in practical use there has been proven no longterm effects on the bacterial levels in saliva.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Huddleston Slater, J.J. F. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:38 |
| Last Modified: | 25 Jun 2020 10:38 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/25 |
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