Prevention of infective endocarditis during dental extractions among Polish dentists - a contemporary nationwide survey.

ABSTRACT

INTRODUCTION: Infective endocarditis (IE) is a potentially life-threatening condition. According to current ESC (European Society of Cardiology) guidelines, the use of antibiotic prophylaxis should only be reserved for specific dental procedures with interruption of consistency of the oral mucosa such as extractions and should be reserved for patients with the highest risk of developing IE. The aim of this study was to assess the knowledge of need for IE prophylaxis in de ned clinical settings among Polish dentists. MATERIAL AND METHODS: A specially self-designed internet questionnaire was created concerning the topic of infective endocarditis prophylaxis in specific clinical scenarios for patients undergoing dental extractions during outpatient visits. The survey was made available to the dentists via internet and was active in March 2018. RESULTS: there were 352 Polish dentists who completed the survey. Antibiotic prophylaxis for IE during dental extractions was used in 93% of cases with prior IE, 89% with artificial heart valve, 69% with biological valve, 28% with pacemaker, 54% with coronary stent, 73% with cyanotic heart defect, 58% with diabetes mellitus, 20% after prior myocardial infarction and 54% with heart valve disease. There was a significant relationship between the time of working as a physician (>15 years) and more outdated or improper IE prophylaxis (p = 0.04). CONCLUSIONS: the management of patients for infective endocarditis prophylaxis undergoing dental extractions is suboptimal. Antibiotic therapy is overused in some clinical scenarios and on the other hand underutilized in those recommended by the current ESC guidelines.