scholarly journals History of Antimicrobial Prophylaxis Protocols for Infective Endocarditis Secondary to Dental Procedures

Author(s):  
Inmaculada Toms ◽  
Maximiliano lvarez-Fernndez
2011 ◽  
Vol 1 (4) ◽  
pp. 92
Author(s):  
Roberta Doria ◽  
Enrico Tagliaferri ◽  
Giovanni Andreotti ◽  
Riccardo Taddei ◽  
Rubinia Nardini ◽  
...  

A young girl was admitted for fever, headache, paresthesia of the hands, involuntary blinking of the left eye and aphasia. Imaging revealed mycotic cerebral aneurysms and finally infective endocarditis was diagnosed and successfully treated with daptomycin. She had a history of mitral prolapse and she had undergone dental procedures some months before without any antibiotic prophylaxis, according to the 2007 guidelines of the American Heart Association.


2015 ◽  
Vol 9 (1) ◽  
pp. 176-180 ◽  
Author(s):  
Maha A Bahammam ◽  
Noha M Abdelaziz

Introduction : Infective endocarditis is a serious infection of the heart endothelium and valves. It carries long-term health risks and compromises the heart condition. However, this condition has been rarely observed since the introduction of appropriate antibiotic prophylaxis. Dentists play a major role in preventing infective endocarditis in susceptible patients. In this study, we assessed the levels of awareness about antibiotic prophylaxis for infective endocarditis among students and young dentists at King Abdulaziz University, Jeddah, Saudi Arabia. Methods : This cross-sectional study included 367 dental students and dental interns who answered a questionnaire designed to assess their awareness levels; it included questions pertaining to demographic information and questions examining the general knowledge of the participants with regard to antibiotic prophylaxis for infective endocarditis. Results : An average of 50% of the participants clearly lacked knowledge regarding the conditions that require antibiotic prophylaxis, while an average of 65% provided correct answers pertaining to the conditions that do not require prophylaxis. Regarding dental procedures that require prophylaxis, the majority of responses were correct with an average of 71.2%. With regard to the type of antibiotic to be prescribed, 63.5% of the participants chose to prescribe 2 g of amoxicillin as a first-line antibiotic. Conclusion : The results of this study showed that the levels of awareness about antibiotic prophylaxis for infective endocarditis are below 100%. Awareness is essential because of the cardiac risks associated with the lack of appropriate treatment. Up-to-date and accurate knowledge is mandatory for all dental students and interns who see and treat patients on a daily basis.


2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling

Abstract Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P <  0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P <  0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P <  0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P <  0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P <  0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P <  0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P <  0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P <  0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P <  0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Alraddadi ◽  
A Alsagheir ◽  
S Gao ◽  
K An ◽  
H Hronyecz ◽  
...  

Abstract Background Managing endocarditis in intravenous drug use (IVDU) patients is challenging: unless patients successfully quit IVDU, the risk of re-infection is high. Clinicians often raise concerns with ethical and resource allocation principles when considering valve replacement surgery in this patient population. To help inform practice, we sought to determine the long-term outcomes of IVDU patients with endocarditis who underwent valve surgery in our center. Method After research ethics board approval, infective endocarditis cases managed surgically at our General Hospital between 2009 and 2018 were identified through the Cardiac Care Network. We reviewed patients' charts and included those with a history of IVDU in this study. We abstracted data on baseline characteristics, peri-operative course, short- and long-term outcomes. We report results using descriptive statistics. Results We identified 124 IVDU patients with surgically managed endocarditis. Mean age was 37 years (SD 11), 61% were females and 8% had redo surgery. During admission, 45% (n=56) of the patients had an embolic event: 63% pulmonary, 30% cerebral, 18% peripheral and 11% mesenteric. Causative organisms included Methicillin-Sensitive Staphylococcus Aureus (51%, n=63), Methicillin-Resistant Staphylococcus Aureus (15%, n=19), Streptococcus Viridans (2%, n=2), and others (31%, n=38). Emergency cardiac surgery was performed for 42% of patients (n=52). Most patients (84%) had single valve intervention: 53% tricuspid, 18% aortic and 13% mitral. Double valve interventions occurred in 15% (n=18). Overall, bioprosthetic replacement was most commonly chosen (79%, n=98). In-hospital mortality was 7% (n=8). Median length of stay in hospital was 13 days (IQR 8,21) and ICU 2 days (IQR 1,6). Mortality at longest available follow-up was 24% (n=30), with a median follow-up of 129 days (IQR 15,416). Valve reintervention rate was 11% (n=13) and readmission rate was 14% (n=17) at a median of 275 days (IQR 54,502). Conclusion Despite their critical condition, IVDU patients with endocarditis have good intra-hospital outcomes. Challenges occur after hospital discharge with loss of follow-up and high short-term mortality. IVDU relapse likely accounts for some of these issues. In-hospital and community comprehensive addiction management may improve these patients' outcomes beyond the surgical procedure. Annual rate 2009–2018 Funding Acknowledgement Type of funding source: None


2014 ◽  
Vol 8 (1) ◽  
pp. 56-59 ◽  
Author(s):  
Motoki Sonohata ◽  
Masaru Kitajima ◽  
Syunsuke Kawano ◽  
Masaaki Mawatari

The risk of periprosthetic joint infection from hematogenous bacterial seeding is increased in patients undergoing dental procedures that facilitate the development of bacteremia. We herein report the case of a patient without a history of dental procedures who suffered from an acute metastatic infection of a hip prosthesis by the oral bacterium Streptococcus mutans 18 months after undergoing revision total hip arthroplasty. The patient was successfully treated by two-stage revision surgery. It is important to realize that the efficacy of antibiotic prophylaxis against joint infections has not yet been convincingly proven. As a result, optimal dental hygiene and regular dental visits may be more important than antibiotic prophylaxis for maintaining joint health. Therefore, orthopedic surgeons should educate patients with joint prostheses about good oral health.


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