Vol.68 No.1 January 2020
Future direction of antibiotic prophylaxis for invasive dental procedures -from the view of the Revision Committee of the Guidelines for Prevention and Treatment of Infective Endocarditis in Japan
1)Division of Community Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, Japan
2)Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
Abstract
Antibiotic prophylaxis for invasive dental procedures to prevent infective endocarditis (IE) had been prescribed since the 1950s. However, the recommendations were partially or totally abandoned in the 1990s in Europe and the US. In the process of revising the guidelines in Japan, we collected items of evidence and discussed the following issues: 1) The prevalence of IE associated with the dental procedure for which it was prescribed, 2) Risk stratification for IE for background diseases, 3) Change in the of IE in Europe and US after the modification of the guidelines, 4) Results of a cost benefit analysis of antibiotic prophylaxis, 5) Recognition of and compliance with the guidelines by doctors and dentists, and 6) Adverse effects related to antibiotic prophylaxis. As a consequence of the discussions, the revised guidelines by the Japanese Circulation Society in 2017 recommend antibiotic prophylaxis both for the highest- and moderate-risk patients. The English version of the guidelines have already been published in 2019. Publicizing and validation of the new guidelines are needed in the future.
Received
March 14, 2019
Accepted
August 19, 2019
Jpn. J. Chemother. 68 (1): 116-124, 2020
