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Current Oral Health Reports

, Volume 5, Issue 1, pp 19–25 | Cite as

Implications of Antimicrobial Usage to Prevent Bacteremia for Periodontal Therapy

  • Nurcan BuduneliEmail author
Systemic Diseases (N Buduneli, Section Editor)
  • 66 Downloads
Part of the following topical collections:
  1. Topical Collection on Systemic Diseases

Abstract

Purpose of Review

This review examines the current literature on periodontal treatment, bacteremia and prophylactic antibiotic usage to prevent the systemic adverse outcomes.

Recent Findings

Currently, it is not clear whether prophylactic antibiotic administration prevents bacterial endocarditis in patients with high risk.

Summary

Recent publications have resulted in significant changes in the concept of antibiotic prophylaxis. Available evidence does not support the previously published guidelines recommending prophylactic antibiotic usage prior to dental treatment. Potential harms and costs of antibiotic administration should be weighed against expected benefits. Clinicians are advised to discuss the potential benefits and harms of antibiotic prophylaxis with their patients before prescription.

Keywords

Periodontal diseases Bacteremia Bacterial endocarditis Antibiotics Periodontal treatment 

Notes

Compliance with Ethical Standards

Conflict of Interest

The author declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Dewhirst FE, Chen T, Izard J, Paster BJ, Tanner ACR, Yu WH, et al. The human oral microbiom. J Bacteriol. 2010;192(19):5002–17.  https://doi.org/10.1128/JB.00542-10.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Larsen T, Fiehn N-E. Dental biofilm infections—an update. APMIS. 2017;125(4):376–84.  https://doi.org/10.1111/apm.12688.CrossRefPubMedGoogle Scholar
  3. 3.
    Miller WD. The micro-organisms of the human mouth: the local and general diseases which are caused by them. Philadelphia: SS White; 1880.Google Scholar
  4. 4.
    Roberts HL. Focal infection. Br J Dermatol. 1921;33(11):353–73.  https://doi.org/10.1111/j.1365-2133.1921.tb09007.x.CrossRefGoogle Scholar
  5. 5.
    Forner L, Larsen T, Kilian M, Holmstrup P. Incidence of bacteremia after chewing, tooth brushing and scaling in individuals with periodontal inflammation. J Clin Periodontol. 2006;33(6):401–7.  https://doi.org/10.1111/j.1600-051X.2006.00924.x.CrossRefPubMedGoogle Scholar
  6. 6.
    Crasta K, Daly CG, Mitchell D, Curtis B, Stewart D, Heitz-Mayfield LJ. Bacteremia due to dental flossing. J Clin Periodontol. 2009;36(4):323–32.  https://doi.org/10.1111/j.1600-051X.2008.01372.x.CrossRefPubMedGoogle Scholar
  7. 7.
    Zhang W, Daly CG, Mitchell D, Curtis B. Incidence and magnitude of bacteremia caused by flossing and by scaling and root planning. J Clin Periodontol. 2013;40(1):41–52.  https://doi.org/10.1111/jcpe.12029.CrossRefPubMedGoogle Scholar
  8. 8.
    Olsen I, van Winkelhoff AJ. Acute focal infections of oral origin. Periodontol. 2014;65(1):178–89.  https://doi.org/10.1111/prd.12018.CrossRefGoogle Scholar
  9. 9.
    Cahill TJ, Prendergast BD. Infective endocarditis. Lancet. 2015;387:882–93.CrossRefPubMedGoogle Scholar
  10. 10.
    Hoen B, Duval X. Infective endocarditis. N Engl J Med. 2013;369:785.CrossRefPubMedGoogle Scholar
  11. 11.
    Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG Jr, Bayer AS, et al. Clinical presentation, etiology and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009;169(5):463–73.  https://doi.org/10.1001/archinternmed.2008.603.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Van der Meer JT, Thompson J, Valkenburg HA, et al. Epidemiology of bacterial endocarditis in the Netherlands II antecedent procedures and uses of prophylaxis. Arch Intern Med. 1992;152(9):1869–73.CrossRefPubMedGoogle Scholar
  13. 13.
    Horder TJ. Infective endocarditis: with an analysis of 150 cases and with special reference to the chronic form of the disease. QJM. 1909;os2:289–324.Google Scholar
  14. 14.
    Lewis T, Grant R. Observations relating to subacute infective endocarditis. Heart. 1923;10:21–77.Google Scholar
  15. 15.
    Okell CC, Elliott SD. Bacteremia and oral sepsis: with special reference to the etiology of subacute endocarditis. Lancet. 1935;226(5851):869–72.  https://doi.org/10.1016/S0140-6736(00)47788-3.CrossRefGoogle Scholar
  16. 16.
    Otten JE, Pelz K, Christman G. Anaerobic bacteremia following tooth extraction and removal of osteosynthesis plates. J Oral Maxillofac Surg. 1987;45(6):477–80.  https://doi.org/10.1016/S0278-2391(87)80005-8.CrossRefPubMedGoogle Scholar
  17. 17.
    Lockhart PB. An analysis of bacteremias during dental extraction. A double-blind placebo-controlled study of chlorhexidine. Arch Intern Med. 1996;156(5):513–20.  https://doi.org/10.1001/archinte.1996.00440050059007.CrossRefPubMedGoogle Scholar
  18. 18.
    Range H, Labreuche J, Louedec L, et al. Periodontal bacteria in human carotid atherothrombosis as a potential trigger for neutrophil activation. Atherosclerosis. 2014;236(2):448–55.  https://doi.org/10.1016/j.atherosclerosis.2014.07.034.CrossRefPubMedGoogle Scholar
  19. 19.
    Figuero E, Lindahl C, Marin MJ, et al. Quantification of periodontal pathogens in vascular, blood, and subgingival samples from patients with peripheral arterial disease or abdominal aortic aneurymsms. J Periodontol. 2014;85(9):1182–93.  https://doi.org/10.1902/jop.2014.130604.CrossRefPubMedGoogle Scholar
  20. 20.
    Dorn BR, Dunn WA Jr, Progulske-Fox A. Invasion of human coronary artery cells by periodontal pathogens. Infect Immun. 1999;67(11):5792–8.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Kozarov E. Bacterial invasion of vascular cell types: vascular infectology and atherogenesis. Futur Cardiol. 2012;8(1):123–38.  https://doi.org/10.2217/fca.11.75.CrossRefGoogle Scholar
  22. 22.
    • Reyes L, Herrera D, Kozarov E, Roldán S, Progulske-Fox A. Periodontal bacterial invasion and infection: contribution to atherosclerotic pathology. J Clin Periodontol. 2013;40(Suppl 14):S30–S50. This article reveals the possible relationship between periodontopathogens and cardiovascular diseases.  https://doi.org/10.1111/jcpe.12079.PubMedGoogle Scholar
  23. 23.
    Wada K, Kamisaki Y. Roles of oral bacteria in cardiovascular diseases–from molecular mechanisms to clinical cases: involvement of Porphyromonas gingivalis in the development of human aortic aneurysm. J Pharmacol Sci. 2010;113(2):115–9.  https://doi.org/10.1254/jphs.09R22FM.CrossRefPubMedGoogle Scholar
  24. 24.
    Mougeot JC, Stevens CB, Paster BJ, Brennan MT, Lockhart PB, Mougeot FK. Porphyromonas gingivalis is the most abundant species detected in coronary and femoral arteries. J Oral Microbiol. 2017;9(1):1281562.  https://doi.org/10.1080/20002297.2017.1281562.eCollection2017. CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Vogkou CT, Vlachogiannis NI, Palaiodimos L, Kousoulis AA. The causative agents in infective endocarditis: a systematic review comprising 33,214 cases. Eur J Clin Microbiol Infect Dis. 2016;35(8):1227–45.  https://doi.org/10.1007/s10096-016-2660-6.CrossRefPubMedGoogle Scholar
  26. 26.
    Kaplan EL, Anderson RC. Infective endocarditis after use of dental irrigation device. Lancet. 1977;2:610.CrossRefPubMedGoogle Scholar
  27. 27.
    Simmons NA, Ball AP, Cawson RA, Eykyn SJ, Littler WA, McGowan DA, et al. Antibiotic prophylaxis and infective endocarditis. Lancet. 1992;339(8804):1292–3.  https://doi.org/10.1016/0140-6736(92)91618-I.CrossRefPubMedGoogle Scholar
  28. 28.
    Dajani AS, Taubert KA, Wilson W, Bolger AF, Bayer A, Ferrieri P, et al. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. Circulation. 1997;96(1):358–66.  https://doi.org/10.1161/01.CIR.96.1.358.CrossRefPubMedGoogle Scholar
  29. 29.
    Gould FK, Elliott TS, Foweraker J, Fulford M, Perry JD, Roberts GJ, et al. Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother. 2006;57(6):1035–42.  https://doi.org/10.1093/jac/dkl121.CrossRefPubMedGoogle Scholar
  30. 30.
    •• National Institute for Health and Care Excellence (NICE). Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures (CG64): last updated 2016 Available at: https://www.nice.org.uk/guidance/cg64. Accessed date 14 Oct 2017. This document is a very important reference, as it reports no significant adverse outcomes by prominently limiting prescription of prophylactic antibiotics.
  31. 31.
    Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116(15):1736–54.  https://doi.org/10.1161/CIRCULATIONAHA.106.183095.CrossRefPubMedGoogle Scholar
  32. 32.
    Barbosa M, Prada-Lopez I, Alvarez M, Amaral B, de los Angeles CD, Tomas I. Post-tooth extraction bacteremia: a randomized clinical trial on the efficacy of chlorhexidine prophylaxis. PLoS One. 2015;10(5):e0124249.  https://doi.org/10.1371/journal.pone.0124249.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Pineiro A, Tomas I, Blanco J, Alvarez M, Seoane J, Diz P. Bacteremia following dental implants’ placement. Clin Oral Implants Res. 2010;21(9):913–8.  https://doi.org/10.1111/j.1600-0501.2010.01928.x.PubMedGoogle Scholar
  34. 34.
    Ugwumba CU, Adeyemo WL, Odeniyi OM, Arotiba GT, Ogunsola FT. Preoperative administration of 0.2% chlorhexidine mouthrinse reduces the risk of bacteremia associated with intra-alveolar tooth extraction. J Craniomaxillofac Surg. 2014;42(8):1783–8.  https://doi.org/10.1016/j.jcms.2014.06.015.CrossRefPubMedGoogle Scholar
  35. 35.
    •• Millot S, Leschlous P, Colombier M-L, et al. Position paper for the evaluation and management of oral status in patients with valvular disease. Arch Cardiovasc Dis. 2017;110(8–9):482–494. This position paper indicates that very few patients really benefit from antibiotic prophylaxis.  https://doi.org/10.1016/j.acvd.2017.01.012.CrossRefPubMedGoogle Scholar
  36. 36.
    Jones TD, Baumgartner L, Bellows MT, et al. Prevention of rheumatic fever and bacterial endocarditis through control of streptococcal infections. Circulation. 1955;11:317–20.Google Scholar
  37. 37.
    Thomas DW, Hill CM. An audit of antibiotic prescribing in third molar surgery. Br J Oral Maxillofac Surg. 1997;35(2):126–8.  https://doi.org/10.1016/S0266-4356(97)90688-4.CrossRefPubMedGoogle Scholar
  38. 38.
    Lawler B, Sambrook PJ, Goss AN. Antibiotic prophylaxis for dentoalveolar surgery: is it indicated? Aust Dent J. 2005;50:554–9.CrossRefGoogle Scholar
  39. 39.
    Danchin N, Duval X, Leport C. Prophylaxis of infective endocarditis: French recommendations 2002. Heart. 2005;91(6):715–8.  https://doi.org/10.1136/hrt.2003.033183.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Pallasch TJ. Antibiotic resistance. Dent Clin N Am. 2003;47(4):623–39.  https://doi.org/10.1016/S0011-8532(03)00039-9.CrossRefPubMedGoogle Scholar
  41. 41.
    •• Lockhart PB, Brennan MT, Sasser HC, Fox PC, Paster BJ, Bahrani-Mougeot FK. Bacteremia associated with tooth brushing and dental extraction. Circulation. 2008;117(24):3118–3125. This article demonstrates the higher risk of bacteremia associated with toothbrushing.  https://doi.org/10.1161/CIRCULATIONAHA.107.758524.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Veloso TR, Amiguet M, Rousson V, Giddey M, Vouillamoz J, Moreillon P, Entenza JM Induction of experimental endocarditis by continuous low-grade bacteremia mimicking spontaneous bacteremia in humans. Infect Immun 2011;79:2006–11, 5, DOI:  https://doi.org/10.1128/IAI.01208-10.
  43. 43.
    Roberts GJ. Dentists are innocent! “Everyday” bacteremia is the real culprit: a review and assessment of the evidence that dental surgical procedures are a principal cause of bacterial endocarditis in children. Pediatr Cardiol. 1999;20(5):317–25.  https://doi.org/10.1007/s002469900477.CrossRefPubMedGoogle Scholar
  44. 44.
    Pallasch TJ. Antibiotic prophylaxis problems in paradise. Dent Clin N Am. 2003a;47(4):665–79.  https://doi.org/10.1016/S0011-8532(03)00037-5.CrossRefPubMedGoogle Scholar
  45. 45.
    Farbod F, Kanaan H, Farbod J. Infective endocarditis and antibiotic prophylaxis prior to dental/oral procedures: latest revision to the guidelines by the American Heart Association published April 2007. Int J Oral Maxillofac Surg. 2009;38(6):626–31.  https://doi.org/10.1016/j.ijom.2009.03.717.CrossRefPubMedGoogle Scholar
  46. 46.
    Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, del Zotti F, et al. 2015 ESC guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36(44):3075–128.  https://doi.org/10.1093/eurheartj/ehv319.CrossRefPubMedGoogle Scholar
  47. 47.
    Report of a working party of the British Society for Antimicrobial Chemotherapy. The antibiotic prophylaxis of infective endocarditis. Lancet. 1982;2:1323–1326.Google Scholar
  48. 48.
    Leport C, Horstkotte D, Burckhardt D, Suppl B. Antibiotic prophylaxis for infective endocarditis from an international group of experts towards a European consensus. Group of Experts of the International Society for Chemotherapy. Eur Heart J. 1995;16(suppl B):126–31.  https://doi.org/10.1093/eurheartj/16.suppl_B.126.CrossRefPubMedGoogle Scholar
  49. 49.
    Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A, et al. Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary; the task force on infective endocarditis of the European society of cardiology. Eur Heart J. 2004;25(3):267–76.  https://doi.org/10.1016/j.ehj.2003.11.008.CrossRefPubMedGoogle Scholar
  50. 50.
    National Institute for Health and Care Excellence (NICE). Prophylaxis against infective endocarditis-Appendix 6. de novo economic analysis. Secondary prophylaxis against infective endocarditis. 2008; Volume: pages. http://www.nice.org.uk/guidance/cg64. Accessed on 23 Oct 2017.
  51. 51.
    National Institute for Health and Care Excellence (NICE). Prophylaxis against infective endocarditis. Secondary prophylaxis against infective endocarditis. 2015; Volume: pages. http://www.nice.org.uk/guidance/cg64. Accessed on 23 Oct 2017.
  52. 52.
    Thornhill MH, Dayer M, Lockhart PB, McGurk M, Shanson D, Prendergast B, et al. A change in the NICE guidelines on antibiotic prophylaxis. BDJ. 2016;221(3):112–4.  https://doi.org/10.1038/sj.bdj.2016.554.CrossRefPubMedGoogle Scholar
  53. 53.
    Dayer MJ, Jones S, Prendergast B, Baddour LM, Lockhart PB, Thornhill MH. Incidence of infective endocarditis in England, 2000-13: a secular trend, interrupted time-series analysis. Lancet. 2015;385:1211228.CrossRefGoogle Scholar
  54. 54.
    •• Thornhill MH, Dayer M, Lockhart PB, Prendergast B. Antibiotic prophylaxis of infective endocarditis. Curr Infect Dis Rep. 2017;19(2):9. This article provides up-to-date information on the place of antibiotic prophylaxis in prevention of IE.  https://doi.org/10.1007/s11908-017-0564-y.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    •• Taubert KA, Wilson W. Is endocarditis prophylaxis for dental procedures necessary? Heart Asia. 2017;9(1):63–67. This article discusses the efficacy of antibiotic prophylaxis in prevention of IE in the light of current evidence.  https://doi.org/10.1136/heartasia-2016-010810.CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Dale H, Fenstad AM, Hallan G, Havelin LI, Furnes O, Overgaard S, et al. Increasing risk of prosthetic joint infection after total hip arthroplasty. Acta Orthop. 2012;83(5):449–58.  https://doi.org/10.3109/17453674.2012.733918.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    •• Rademacher WMH, Walenkamp GHIM, Moojen DJF, Hendriks JGE, Goedendorp TA, Rozema FR. Antibiotic prophylaxis is not indicated prior to dental procedures for prevention of periprosthetic joint infections. Acta Orthop. 2017;88(5):568–574. This article provides up-to-date information about antibiotic prophylaxis and patients with artificial joints.  https://doi.org/10.1080/17453674.2017.1340041.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Sollecito TP, Abt E, Lockhart PB, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints. JADA. 2015;146:11–6.PubMedGoogle Scholar
  59. 59.
    Costeron JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science. 1999;284(5418):1318–22.  https://doi.org/10.1126/science.284.5418.1318.CrossRefGoogle Scholar
  60. 60.
    Kaplan JB. Antibiotic-induced biofilm formation. Int J Artif Organs. 2011;34(9):737–51.  https://doi.org/10.5301/ijao.5000027.CrossRefPubMedGoogle Scholar
  61. 61.
    •• Holmstrup P, Klausen B. The growing problem of antimicrobial resistance. Oral Dis. 2017;  https://doi.org/10.1111/odi.12610. This article clearly states the importance of antimicrobial resistance and emphasizes how small benefits can be expected out of antibiotic treatment in general.
  62. 62.
    PCAST. Report to the President on combating. President’s Council of Advisors on Science and Technology. 2014.Google Scholar
  63. 63.
    CDC. Antibiotic Resistance Threats in the United States, 2013. Centers for Disease Control and Prevention. 2016.Google Scholar
  64. 64.
    Gelband H, Miller-Petrie M, Pant S et al. Center for Disease Dynamics E and Policy. The State of the World’s Antibiotics 2015. 2016.Google Scholar
  65. 65.
    Bresco-Salinas M, Costa-Riu N, Berini-Aytes L, et al. Antibiotic susceptibility of the bacteria causing odontogenic infections. Med Oral Patol Oral Cir Bucal. 2006;11(1):E70–5.PubMedGoogle Scholar
  66. 66.
    Ready D, Bedi R, Spratt DA, Mullany P, Wilson M. Prevalence, proportions, and identities of antibiotic-resistant bacteria in the oral microflora of healthy children. Microb Drug Resist. 2003;9(4):367–72.  https://doi.org/10.1089/107662903322762806.CrossRefPubMedGoogle Scholar
  67. 67.
    Glenny AM, Roberts OR, Hooper L, Worthington HV. Antibiotics for the prophylaxis of bacterial endocarditis in dentistry (review). Cochrane Database Syst Rev 2013; (10):CD003813.Google Scholar
  68. 68.
    Marcinkiewicz J, Strus M, Pasich E. Antibiotic resistance: a “dark side” of biofilm-associated chronic infections. Pol Arch Med Wewn. 2013;123(6):309–13.PubMedGoogle Scholar
  69. 69.
    Pant S, Patel NJ, Deshmukh A, Golwala H, Patel N, Badheka A, et al. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol. 2015;65(19):2070–6.  https://doi.org/10.1016/j.jacc.2015.03.518.CrossRefPubMedGoogle Scholar
  70. 70.
    Mackie AS, Liu W, Savu A, Marelli AJ, Kaul P. Infective endocarditis hospitalisations before and after the 2007 American Heart Association prophylaxis guidelines. Can J Cardiol. 2016;32(8):942–8.  https://doi.org/10.1016/j.cjca.2015.09.021.CrossRefPubMedGoogle Scholar
  71. 71.
    Mackie AS, Liu W, Savu A, Marelli AJ, Kaul P. Reply to letter from Thornhill et al.—Infective endocarditis hospitalisations before and after the 2007 American Heart Association prophylaxis guidelines. Can J Cardiol. 2016;32(12):1578.e11.  https://doi.org/10.1016/j.cjca.2016.04.002.CrossRefPubMedGoogle Scholar
  72. 72.
    Tubiana S, Blotiere P-O, Hoen B, et al. Dental procedures, antibiotic prophylaxis, and endocarditis among people with prosthetic heart valves: nationwide population based cohort and a case crossover study. BMJ 2017;358.Google Scholar
  73. 73.
    Cahill TJ, Harrison JL, Jewell P, Onakpoya I, Chambers JB, Dayer M, et al. Antibiotic prophylaxis for infective endocarditis: a systematic review and meta-analysis. Heart. 2017;103(12):937–44.  https://doi.org/10.1136/heartjnl-2015-309102.CrossRefPubMedGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Faculty of Dentistry, Department of PeriodontologyEge UniversityİzmirTurkey

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