NICE and antibiotic prophylaxis to prevent endocarditis
NICE and antibiotic prophylaxis to prevent endocarditis
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DOI：
10.1038/sj.bdj.2015.496
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发表时间：
2015-06-01
影响因子：
2.6
通讯作者：
Shanson, D.
中科院分区：
文献类型：
--
作者：
Thornhill, M. H.;Lockhart, P. B.;Shanson, D.
感染性心内膜炎是一种高发病率和死亡率的毁灭性疾病。几十年前，人们就知道口腔细菌与心脏病的关系，牙医、病人和心脏病专家一直在关注这一问题。良好的口腔卫生一直被提倡以预防心内膜炎。在2008年之前，在英国，侵入性牙科手术前的抗生素预防也是预防感染性心内膜炎风险患者的重要策略，在世界上大多数其他国家也是如此。然而，在2008年，NICE发布了新的指南，建议在英国停止抗生素预防。在当时，这是一个极具争议的决定。新的数据表明，自2008年指南发布以来，感染性心内膜炎的发病率显著增加。现正检讨2008年的指引，并草拟新指引，征询公众意见。本文讨论了新数据提出的问题以及在审查和公众咨询中应该解决的问题。
Infective endocarditis is a devastating disease with high morbidity and mortality. The link to oral bacteria has been known for many decades and has caused on going concern for dentists, patients and cardiologists. Good oral hygiene has long been advocated to prevent endocarditis. Before 2008, antibiotic prophylaxis before invasive dental procedures was also an important strategy for preventing infective endocarditis for patients at risk of the disease in the UK, and still is in most other countries of the world. In 2008, however, NICE published new guidance recommending that antibiotic prophylaxis in the UK should cease. At the time this was a highly controversial decision. New data suggests that there has been a significant increase in the incidence of infective endocarditis since the 2008 guidelines. The 2008 guidance is being reviewed and draft new guidance is being put out for public consultation. This article discusses the issues raised by the new data and the questions that should be addressed in the review and public consultation.