Pautas de profilaxis antibiótica de Endocarditis Bacteriana, recomendadas por los odontólogos en España

  1. Tomás Carmona, Inmaculada 1
  2. Diz Dios, Pedro 1
  3. Limeres Posse, Jacobo 1
  4. Outumuro Rial, Mercedes 1
  5. Caamaño Durán, Flor 1
  1. 1 Unidad de Pacientes Especiales, Fac. de Med. y Odontología, Univ. de Santiago de Compostela
Zeitschrift:
Medicina oral

ISSN: 1137-2834

Datum der Publikation: 2004

Ausgabe: 9

Nummer: 1

Seiten: 56-62

Art: Artikel

Andere Publikationen in: Medicina oral

Zusammenfassung

El propósito del presente estudio fue conocer las pautas de profilaxis antibiótica de Endocarditis Bacteriana (EB) recomendadas por los odontólogos en España. Se preguntó a través de una llamada telefónica, cuál era el régimen profiláctico que se debía administrar a un paciente de riesgo de EB antes de someterse a una exodoncia. La información se obtuvo de 400 odontólogos seleccionados aleatoriamente y distribuidos por todo el territorio español. A 200 se les preguntó sobre la pauta recomendada en pacientes no alérgicos a la penicilina y, a los 200 restantes, sobre la aplicada en los alérgicos a la penicilina.Del total de encuestados, 182 (45,5%) no sugirieron ningún régimen profiláctico, de éstos el 74,7% señalaron la necesidad de una cita para una exploración previa y el 25,3% refirieron al paciente a su médico general o cardiólogo. De los 97 odontólogos que recomendaron antibióticos para pacientes no alérgicos a la penicilina, solamente 30 (30,9%) contestaron correctamente algún régimen profiláctico de los publicados por la Asociación Americana de Cardiología o la Sociedad Británica de Quimioterapia Antimicrobiana. Para pacientes alérgicos a la penicilina, el 68,2% de los odontólogos recomendaron eritromicina como antibiótico de elección, y el 17,6% clindamicina. Sin embargo, menos del 30% prescribieron estos antibióticos en las posologías correctas. Estos resultados demuestran una importante carencia de conocimientos entre los odontólogos españoles sobre las pautas de profilaxis de EB para pacientes de riesgo que van a someterse a una manipulación dental.

Bibliographische Referenzen

  • Sekido M, Takano T, Takayama M, Hayakawa H. Survey of infective endocarditis in the last 10 years: Analysis of clinical, microbiological and therapeutic features. J Cardiol 1999;33:209-15.
  • Hricak V, Kovacik J, Marx P, Schramekova E, Fischer V, Vitekova D, et al. Etiology and risk factors of 180 cases of native valve endocarditis. Report from a 5 year national prospective survey in Slovak Republic. Diagn Microbiol Infect Dis 1998;31:431-5.
  • Sandre RM, Shafran SD. Infective endocarditis: Review of 135 cases over 9 years. Clin Infect Dis 1996;22:276-86.
  • Manford M, Matharu J, Farrington K. Infective endocarditis in a district general hospital. J R Soc Med 1992;85:262-6.
  • Tomás Carmona I, Diz Dios P, Limeres Posse J, González Quintela A, Martínez Vázquez C, Castro Iglesias A. An update on infective endocarditis of dental origin. J Dent 2002;30:37-40.
  • Hall G, Heimdahl A, Nord CE. Bacteremia after oral surgery and antibiotic prophylaxis for endocarditis. Clin Infect Dis 1999;29:1-10.
  • American Heart Association. Prevention of bacterial endocarditis. Circulation 1972;46:3-5.
  • Kaplan EL, Anthony BF, Bisno A, Durack D, Houser H, Millard HD, et al. American Heart Association report. Prevention of bacterial endocarditis. Circulation 1977;56:139-43.
  • British Society for Antimicrobial Chemotherapy. Report of a working party. The antibiotic prophylaxis of infective endocarditis. Lancet 1982;2:1323-6.
  • Shulman ST, Amren DP, Bisno AL, Dajani AS, Durack DT. Gerber MA, et al. Prevention of bacterial endocarditis. A statement for health professionals by the committee on rheumatic fever and infective endocarditis of the council on cardiovascular disease in the young. Circulation 1984;70:1123A-7A.
  • British Society for Antimicrobial Chemotherapy. Report of a working party. The antibiotic prophylaxis of infective endocarditis. Lancet 1986;1:1267.
  • Dajani AS, Bisno AL, Chung KJ, Durack DT, Freed M, Gerber MA, et al. Prevention of bacterial endocarditis: Recommendations by the American Heart Association. JAMA 1990;264:2919-22.
  • Antibiotic prophylaxis of infective endocarditis: Recommendations from the endocarditis working party of the British Society for Antimicrobial Chemotherapy. Lancet 1990;335:88-9.
  • Simmons NA. British Society for Antimicrobial Chemotherapy working party report. Recommendations for endocarditis prophylaxis. J Antimicrob Chemother 1993;31:437-8.
  • Leport C, Horstkotte D, Burckhardt D, and the group of experts of the International Society for Chemotherapy. Antibiotic prophylaxis for infective endocarditis from an international group of experts towards a European consensus. Eur Heart J 1995;16:126-31.
  • Dajani AS, Taubert KA, Wilson W, Bolger AF. Bayer A, Ferrieri P, et al. Recommendations by the American Heart Association. Prevention of bacterial endocarditis. Circulation 1997;96:358-66.
  • Wright AJ, Wilson WR. Experimental animal endocarditis. Mayo Clin Proc 1982;57:10-4.
  • Fluckiger U, Moreillon P, Blaser J, Bickle M, Glauser MP, Francioli P. Simulation of amoxicillin pharmacokinetics in humans for the prevention of streptococcal endocarditis in rats. Antimicrob Agents Chemother 1994;38:2846-9.
  • Dankert J, Van Der Werff J, Zaat SA, Joldersma W, Klein D, Hess J. Involvement of bactericidal factors from thrombin-stimulated platelets in clearance of adherent viridans streptococci in experimental infective endocarditis. Infect Immun 1995;63:663-71.
  • Gutschik E, Lippert S. Dental procedures and endocarditis prophylaxis: Experiences from 108 dental practices. Scan J Dent Res 1990;98:144-8.
  • Roberts GJ, Holzel HS, Sury MR, Simmons NA, Gardner P, Longhurst P. Dental bacteremia in children. Pediatr Cardiol 1997;18:24-7.
  • Hall G, Nord CE, Heimdahl A. Elimination of bacteraemia after dental extraction: Comparison of erythromycin and clindamycin for prophylaxis of infective endocarditis. J Antimicrob Chemother 1996;37:783-95.
  • American Heart Association. Prevention of rheumatic fever and bacterial endocarditis through control of streptococcal infections. Circulation 1955;11: 317-20.
  • Nack DT. Current practice in prevention of bacterial endocarditis. Br Heart J 1975;37:478-81.
  • Brooks SL. Survey of compliance with American Heart Association guidelines for prevention of bacterial endocarditis. JADA 1980;101:41-3.
  • Hashway T, Stone LJ. Antibiotic prophylaxis of subacute bacterial endocarditis for adult patients by dentists in Dade County, Florida. Circulation 1982; 66:1110-3.
  • Scully C, Levers BG, Griffiths MJ, Shirlaw PJ. Antimicrobial prophylaxis of infective endocarditis: Effect of BSAC recommendations on compliance in general practice. J Antimicrob Chemother 1987;19:521-6.
  • Nelson CL, Van Blaricum CS. Physician and dentist compliance with American Heart Association guidelines for prevention of bacterial endocarditis. JADA 1989;118:169-73.
  • Vuille C, Bloch A. Do dentists enforce correctly the recommendations for prophylaxis of bacterial endocarditis?. Arch Mal Coeur Vaiss 1992;85:227-32.
  • Forbat LN, Skehan JD. Failure of provision of antibiotic prophylaxis for "at risk" cardiac patients: Impetus for improvement required from cardiologists. Eur Heart J 1993;14:812-8.
  • Bennis A, Soulami S, Khadir R, Chraibi N. Survey on the practice of antibiotic prophylaxis of infective endocarditis by dentists. Arch Mal Coeur Vaiss 1996;89:713-8.
  • Panos G, Giamarellou H, Papazachos G, Birbilis T, Toutouzas P. Greek physicians'and dentists'compliance with the British Society for Antimicrobial Chemotherapy (BSAC) guidelines for preventing bacterial endocarditis. J Chemother 1996;8:270-7.
  • Palmer NA, Pealing R, Ireland RS, Martin MV. A study of prophylactic antibiotic prescribing in National Health Service general dental practice in England. Br Dent J 2000;189:43-6.
  • Epstein JB, Chong S, Le ND. A survey of antibiotic use in dentistry. JADA 2000;131:1600-9.
  • Strom BL, Abrutyn E, Berlin JA, Kinman JL, Feldman RS, Stolley PD, et al. Dental and cardiac risk factors for infective endocarditis. A population-based, case-control study. Ann Intern Med 1998;129:761-8.
  • Durack DT. Antibiotics for prevention of endocarditis during dentistry: Time to scale back?. Ann Intem Med 1998; 129:829-30.
  • Gould IM. Chemoprophylaxis for bacterial endocarditis: A survey of current practice in London. J Antimicrob Chemother 1984;14:379-94.
  • Gohlke-Bärwolf C, Rost M, Roskamm H. Prevention of bacterial endocarditis in Germany. Eur Heart J 1995;16:110-3.
  • Tomás Carmona I, Diz Dios P, Seoane Lestón J, Limeres Posse J. Pautas de profilaxis antibiótica de endocarditis bacteriana en pacientes sometidos a tratamiento odontológico. Rev Clin Esp 2001;201:21-4.
  • Oakley C, Somerville W. Prevention of infective endocarditis. Br Heart J 1981;45:233-5.
  • Holbrook WP, Higgins B, Shaw TRD. Recent changes in antibiotic prophylactic measures taken by dentists against infective endocarditis. J Antimicrob Chemother 1987;20:439-46.
  • Martin MV, Butterworth ML, Longman LP. Infective endocarditis and the dental practitioner: A review of 53 cases involving litigation. Br Dent J 1997; 182:465-8.