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  2. Keyword: Oral Surgical Procedures
Evaluation of Antibiotic Prophylaxis Prescriptions for Infectious Endocarditis Before Oral Procedures Between Cardiologists and Dentists
IJCS
Original Article

Evaluation of Antibiotic Prophylaxis Prescriptions for Infectious Endocarditis Before Oral Procedures Between Cardiologists and Dentists

Mariana Mattos Brandão et al. Luisa Latado Lívia Brito Oliveira Viviane Almeida Sarmento Adriana Lopes Latado

Abstract

Background

Infective endocarditis (IE) is a serious disease with a high mortality rate. Antibiotic prophylaxis for bacterial endocarditis before invasive procedures has been recommended in patients with predisposing cardiac conditions since 1960, but contemporary guidelines worldwide have proposed changes.

Objective

To evaluate the knowledge and pattern of prescription by cardiologists and dentists regarding antibiotic prophylaxis for bacterial endocarditis before risky oral procedures.

Methods

This is an observational and cross-sectional study. Data were obtained from an online questionnaire, sent to cardiologists and dentists linked to specialty societies, in the first semester of 2021. Data analysis was performed using descriptive statistics, and comparisons between variables were done in an exploratory approach. The significance level adopted was 5%.

Results

From 613 responders, 82.5% of cardiologists and 79.5% of dentists reported prescribing antibiotic prophylaxis for patients at high and moderate risk for IE. Of dental procedures capable of generating bacteremia, all were correctly identified by more than 50.0% of the sample. As for the habits of daily living, flossing and toothbrushing had almost 50.0% of correct answers, chewing had only 17.3%, and 40.9% reported that none of the actions presented a risk of bacteremia. When comparing variables, the correct prescription of amoxicillin (2 g, 30–60 minutes before the procedure) was more prevalent among cardiologists and in responders with less than 20 years of graduation (p<0.01).

Conclusion

In the present study, the prescription of antibiotic prophylaxis for IE were frequent for high- and moderate-risk patients, before oral/dental procedures. Partial knowledge was found about endocarditis, which highlights the need for continuous medical/dental education.

  • Antibiotic Prophylaxis
  • Bacterial Endocarditis
  • Cross-sectional Study
  • Oral Surgical Procedures
  • Prescriptions
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Creative Commons Attribution (CC BY) Creative Commons license
22/12/2023 DOI: 10.36660/ijcs.20230034 Views 1
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ABC
Original Article

Evaluation of the Bleeding Intensity of Patients Anticoagulated with Warfarin or Dabigatran Undergoing Dental Procedures

Marcus Vinicius Santos Andrade et al. Luciana Azevedo Prata Andrade Alan Freitas Bispo Luana de Alencar Freitas … Milena Quadros Sampaio Andrade Gilson Soares Feitosa Gilson Soares Feitosa-Filho

Abstract

Background:

Thrombotic disorders remain one of the leading causes of death in the Western world. Dabigatran appeared as an alternative to warfarin for anticoagulation in the treatment of atrial fibrillation (AF). The risk associated with bleeding due to its use has been documented in several randomized clinical trials, but no large study has examined in detail the risk of bleeding during dental extraction and other dental procedures involving bleeding.

Objective:

To compare the intensity of bleeding in individuals taking dabigatran or vitamin K antagonist (warfarin) and undergoing dental procedures.

Methods:

Prospective, single-center, controlled study with one single observer. Patients diagnosed with nonvalvular AF, on warfarin or dabigatran, cared for at a cardiology referral center, and requiring single or multiple dental extractions, were evaluated up to seven days post-extraction. The following outcomes were assessed: bleeding time between the beginning and the end of suture and complete hemostasis; bleeding before the procedure, after 24 hours, 48 hours, 7 days, during and after suture removal (late); p<0.05 was defined as of statistical relevance.

Results:

We evaluated 37 individuals, 25 in the warfarin group and 12 in the dabigatran group. Age, sex, weight, height, blood pressure, color, schooling, family income and comorbidities were similar between the two groups. Regarding bleeding after 24 hours of the procedure, no one in the dabigatran group had bleeding, whereas 32% in the warfarin group had documented bleeding (p = 0.028). The other variables analyzed did not differ between the groups.

Conclusions:

This study suggests that, regarding dental extraction, there is no statistically significant difference in the intensity of bleeding of patients taking dabigatran as compared to those taking warfarin. Bleeding 24 hours after the procedure was less frequent among patients on dabigatran.

  • Anticoagulants
  • Bleeding Time
  • Dabigatran
  • Hemorrhage/complications
  • Oral Surgical Procedures
  • Warfarin
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Creative Commons Attribution (CC BY) Creative Commons license
06/08/2018 DOI: 10.5935/abc.20180137 Views 2

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Brandão MM, Latado L, Oliveira LB, Sarmento VA, Latado AL. Evaluation of Antibiotic Prophylaxis Prescriptions for Infectious Endocarditis Before Oral Procedures Between Cardiologists and Dentists. International Journal of Cardiovascular Sciences 2023;36:e20230034.

Electronic Document Format (ABNT)

Brandão, Mariana Mattos; Latado, Luisa; Oliveira, Lívia Brito; Sarmento, Viviane Almeida; Latado, Adriana Lopes. Evaluation of Antibiotic Prophylaxis Prescriptions for Infectious Endocarditis Before Oral Procedures Between Cardiologists and Dentists. International Journal of Cardiovascular Sciences, v. 36, e20230034, Dec. 2023.

Electronic Document Format (APA)

Brandão, M. M., Latado, L., Oliveira, L. B., Sarmento, V. A., & Latado, A. L. (2023). Evaluation of Antibiotic Prophylaxis Prescriptions for Infectious Endocarditis Before Oral Procedures Between Cardiologists and Dentists. International Journal of Cardiovascular Sciences, 36, e20230034.

Electronic Document Format (ISO)

Brandão, Mariana Mattos and Latado, Luisa and Oliveira, Lívia Brito and Sarmento, Viviane Almeida and Latado, Adriana Lopes. Evaluation of Antibiotic Prophylaxis Prescriptions for Infectious Endocarditis Before Oral Procedures Between Cardiologists and Dentists. International Journal of Cardiovascular Sciences [online]. 2023, vol. 36, [cited 2026-10-14], e20230034. Available from: <https://journals.cardiol.br/en/article/evaluation-of-antibiotic-prophylaxis-prescriptions-for-infectious-endocarditis-before-oral-procedures-between-cardiologists-and-dentists/>. ISSN 2359-4802

EndNote RIS

Electronic Document Format (Vancouver)

Andrade MVS, Andrade LAP, Bispo AF, Freitas LA, Andrade MQS, Feitosa GS, Feitosa-Filho GS, et al. Evaluation of the Bleeding Intensity of Patients Anticoagulated with Warfarin or Dabigatran Undergoing Dental Procedures. Arquivos Brasileiros de Cardiologia 2018;111(3):394-9.

Electronic Document Format (ABNT)

Andrade, Marcus Vinicius Santos; Andrade, Luciana Azevedo Prata; Bispo, Alan Freitas; Freitas, Luana de Alencar; Andrade, Milena Quadros Sampaio; Feitosa, Gilson Soares; Feitosa-Filho, Gilson Soares. Evaluation of the Bleeding Intensity of Patients Anticoagulated with Warfarin or Dabigatran Undergoing Dental Procedures. Arquivos Brasileiros de Cardiologia, v. 111, n. 3, p. 394-399, Aug. 2018.

Electronic Document Format (APA)

Andrade, M. V. S., Andrade, L. A. P., Bispo, A. F., Freitas, L. A., Andrade, M. Q. S., Feitosa, G. S., & Feitosa-Filho, G. S. (2018). Evaluation of the Bleeding Intensity of Patients Anticoagulated with Warfarin or Dabigatran Undergoing Dental Procedures. Arquivos Brasileiros de Cardiologia, 111(3), 394-399.

Electronic Document Format (ISO)

Andrade, Marcus Vinicius Santos and Andrade, Luciana Azevedo Prata and Bispo, Alan Freitas and Freitas, Luana de Alencar and Andrade, Milena Quadros Sampaio and Feitosa, Gilson Soares and Feitosa-Filho, Gilson Soares. Evaluation of the Bleeding Intensity of Patients Anticoagulated with Warfarin or Dabigatran Undergoing Dental Procedures. Arquivos Brasileiros de Cardiologia [online]. 2018, vol. 111, n. 3, [cited 2026-10-14], pp. 394-399. Available from: <https://journals.cardiol.br/en/article/evaluation-of-the-bleeding-intensity-of-patients-anticoagulated-with-warfarin-or-dabigatran-undergoing-dental-procedures/>. ISSN 0066-782X

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