Do Invasive Dental Procedures Cause Prosthetic Joint Infections (PJI)? - The PJI Study
Do Invasive Dental Procedures Cause Prosthetic Joint Infections (PJI)? - The PJI Study
批准号:
9982680
负责人:
PETER B LOCKHART
金额:
$12.43万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2018
资助国家:
美国
项目状态:
已结题
起止时间:
2018-09-05 至 2022-08-31
关键词:
AddressAdoptionAdverse reactionsAmericanAmerican Dental AssociationAntibiotic ProphylaxisAntibiotic-resistant organismAntibioticsBacteremiaBacteriaBacterial Antibiotic ResistanceBloodBlood CirculationCase-Control StudiesClinical TrialsComplicationConflict (Psychology)ConfusionCross-Over StudiesDataDentalDental CareDental RecordsDentistsDevelopmentDiagnosisDiseaseEnglandFrequenciesFutureGuidelinesHealth Care CostsHospitalizationHospitalsIncidenceIndividualInformation SystemsJoint ProsthesisJointsLinkMethodologyMethodsModern MedicineMorbidity - disease rateNational Health ServicesOperative Surgical ProceduresOrthopedicsOutcomePatientsPopulationProceduresProsthesisPublic HealthPulp CanalsRecommendationRiskSavingsSocietiesSurgeonTechniquesTestingTooth structureTreatment Costadverse drug reactionbasecase controlclinical practicecostimprovedjoint infectionjoint injurymortalitypatient populationpreventsocietal costsstatistics
中文摘要
项目总结/文摘
英文摘要
Project Summary/Abstract
Background: Prosthetic replacement of diseased and damaged joints is one of the great advances of modern
medicine. Prosthetic joint infections (PJI) however are a serious complication. Improved operative techniques
have reduced the risk of PJI soon after surgery but late PJI (LPJI) are an ongoing risk for the >7 million individuals
with a prosthetic joint in the US. In an attempt to reduce this risk dentists are encouraged to give prosthetic joint
patients antibiotics before invasive dental procedures (IDP) to reduce the risk of bacteria entering the circulation
and infecting the joint. This is called antibiotic prophylaxis (AP). However, there has never been a trial to
demonstrate AP efficacy and there is little evidence to support an association between IDP and LPJI. As a result,
AP guidelines are confused and differ around the world. In the US, AP is widely used although the AP guidelines
are unclear and baffling for both clinicians and their patients. In contrast, AP has never been used in the UK. To
resolve this confusion and guide clinicians, data proving or disproving any association between IDP and LPJI is
urgently needed. If an association exists, then the widespread adoption of AP could help reduce the ~20,000
cases and ~$566 million annual cost of LPJI in the US. If not, then AP is unnecessary and could be stopped saving
~$60 million annually, avoiding the risk of adverse reactions to AP antibiotics and the risk to society that AP may
promote the development of antibiotic resistant bacteria.
Objectives: To determine if IDP are causally associated with the development of LPJI or not.
Specific Aims: (i) To perform a case-crossover study to determine if the frequency of IDP in the 3 months
immediately preceding LPJI is significantly greater than in earlier 3 month matched control periods i.e. 3-6, 6-9
and 9-12 months before the LPJI. (ii) We will also perform a case control study comparing the incidence of dental
treatment involving and not involving an IDP in the 3 months preceding an LPJI.
Methods: We will use national Hospital Episode Statistics (HES) data to identify LPJI patients in England from
2010-2017. We will use English data because (i) AP, that could hide any association between IDP and LPJI, has
never been used in England and (ii) the UK National Health Service (NHS) data systems allows us to link courses
of dental treatment (CoT) to cases of LPJI. Using each LPJI patient’s NHS number we can link the LPJI data to
each individual’s dental data. This will allow us to determine if patients who develop LPJI had a CoT in the
preceding year, if it involved an IDP or not and when it occurred in relation to the hospital admission. We will use
the powerful case-crossover analysis method to determine if the incidence of IDP in the 3 months preceding LPJI
(case periods) was significantly higher, or not, than the incidence in each of the earlier 3 month periods (3-6, 6-9
and 9-12 months before LPJI). A more traditional case-control analysis will also be performed to see if CoT
involving an IDP occurred significantly more frequently than CoT not involving an IDP in the 3 months preceding
an IDP. These methods will provide the statistical power to determine if IDP are associated with LPJI or not.
期刊论文(1)
专著(0)
科研奖励(0)
会议论文
DOI:
10.1001/jamanetworkopen.2021.42987
发表时间:
2022-01-04
期刊:
JAMA network open
影响因子:
13.8
作者:
[Thornhill MH, Crum A, Rex S, Stone T, Campbell R, Bradburn M, Fibisan V, Lockhart PB, Springer B, Baddour LM, Nicholl J]
通讯作者:
Nicholl J
Randomized Trial of non-Surgical Therapy and Oral Hygiene Instruction to Reduce Risk of Infective Endocarditis
-
批准号:10746079
-
项目类别:
-
资助金额:$117.97万
-
财政年份:2023
-
负责人:PETER B LOCKHART
-
依托单位:
Randomized Trial of non-Surgical Therapy and Oral Hygiene Instruction to Reduce Risk of Infective Endocarditis
-
批准号:10348489
-
项目类别:
-
资助金额:$66.08万
-
财政年份:2022
-
负责人:PETER B LOCKHART
-
依托单位:
Oral Hygiene, Periodontal Disease, and Infective Endocarditis
-
批准号:9118953
-
项目类别:
-
资助金额:$79.36万
-
财政年份:2014
-
负责人:PETER B LOCKHART
-
依托单位:
Oral Hygiene, Periodontal Disease, and Infective Endocarditis
-
批准号:8900261
-
项目类别:
-
资助金额:$79.64万
-
财政年份:2014
-
负责人:PETER B LOCKHART
-
依托单位:
Oral Hygiene, Periodontal Disease, and Infective Endocarditis
-
批准号:8693180
-
项目类别:
-
资助金额:$76.63万
-
财政年份:2014
-
负责人:PETER B LOCKHART
-
依托单位:
World Workshop in Oral Medicine IV
-
批准号:7000515
-
项目类别:
-
资助金额:$3.47万
-
财政年份:2005
-
负责人:PETER B LOCKHART
-
依托单位:
Bacteremia from Dental Extraction vs. Oral Hygiene
-
批准号:6621878
-
项目类别:
-
资助金额:$54.66万
-
财政年份:2002
-
负责人:PETER B LOCKHART
-
依托单位:
Bacteremia from Dental Extraction vs. Oral Hygiene
-
批准号:6748923
-
项目类别:
-
资助金额:$56.27万
-
财政年份:2002
-
负责人:PETER B LOCKHART
-
依托单位:
Bacteremia from Dental Extraction vs. Oral Hygiene
-
批准号:6437173
-
项目类别:
-
资助金额:$57.18万
-
财政年份:2002
-
负责人:PETER B LOCKHART
-
依托单位:
RESIDENCY TRAINING IN THE GENERAL PRACTICE OF DENTISTRY
-
批准号:3016014
-
项目类别:
-
资助金额:$0.0万
-
财政年份:1985
-
负责人:PETER B LOCKHART
-
依托单位:
RESIDENCY TRAINING IN THE GENERAL PRACTICE OF DENTISTRY
-
批准号:3016013
-
项目类别:
-
资助金额:$0.0万
-
财政年份:1985
-
负责人:PETER B LOCKHART
-
依托单位:
海外基金