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 with countries that do not suggest 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, potentially contributing to an increase in antibiotic resistance and, on the other hand, to the lack of scientific evidence for the use of this type of prophylaxis to prevent 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 paper, 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.
Antibiotic Prophylaxis and Infective Endocarditis Incidence Following Invasive Dental Procedures A Systematic Review and Meta-Analysis
JAMA Cardiol. Published online April 6, 2024. doi:10.1001/jamacardio.2024.0873
jamacardiology_sperotto.pdf
