Sportel, G.E.Y. (2015) Onderzoek naar bepalende factoren omtrent de vigerende endocarditisprofylaxe richtlijn. thesis, Dentistry.
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Abstract
The purpose of the present study was to answer the key question: what factors are decisive in the consideration of the current endocarditis prophylaxis directive and how do these factors determine the application in dentistry? Therefore, a literature review has been carried out. Factors in balancing the prophylaxis were examined. The social relevance plays a major role, given the high mortality of the disease. The last few years, the prophylaxis directive has been criticized and amended several times. This study focuses on the social and dental discussion, which includes the compliance of dental professionals and the high probability of resistance to antibiotics due to the over prescription that might take place because of the prophylaxis. The search has been performed using PubMed, EMBASE, Web Of Science and Cochrane Central Register of Controlled Trials with the terms “(endocarditis AND dentistry) AND (bacteremia OR antibiotic resistance OR compliance)”. A total of 33 articles were included after application of inclusion and exclusion criteria. The results of this literature study show that patients with plaque and/or calculus have a greater chance of developing a bacteremia than patients without these aspects. The percentages of a bacteremia in various dental treatments are diverse. Once in every four years, a treatment procedure occurs where there is a possibility of the emergence of a bacteremia. A prophylactic antibiotic reduces the risk of a bacteremia. If a professional is familiar with the prophylaxis, there is a large compliance. Antibiotics, however, are prescribed frequently when there is no indication and vice versa. Frequent use of amoxicillin leads to an increase of resistance although a bacteremia is not completely eliminated by this prophylaxis. The relationship between dental treatments and infective endocarditis has not yet been completely revealed. Studies have ascertained that only a small part of the infective endocarditis cases have been initiated by dental procedures. The burden of bacteremia after routine daily activity also surpasses the fugitive bacteremia after dental procedures. It is still unclear whether the possible damage and the cost of prescribing antibiotics outweigh the benefits. Based on the data found in this literature study, several factors are decisive in the consideration of the current prophylaxis guideline such as the development of a bacteremia, the compliance of dental professionals, the chance of resistance against antibiotics and the possible consequences of using these antibiotics. Further research about the existence of a bacteremia after dental procedures is required to solve questions about these influencing factors. A possible adjustment in the current guideline may provide more clarity in the applicability.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Spijkervet, Prof. dr. F.K.L. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:05 |
| Last Modified: | 25 Jun 2020 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2506 |
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