歯科・口腔外科処置における感染性心内膜炎予防に関する意識調査

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  • A questionnaire survey about the prevention of infective endocarditis associated with dental treatment and oral surgery

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Infective endocarditis (IE) is the most important complication in dentistry and oral surgery. Patients with a history of congenital heart disease or valvular disease are at high risk for IE and are therefore given prophylactic treatment with antimicrobial agents. Currently, however, there is no standard treatment; prophylactic treatments vary among different institutions. The Japanese Circulation Society is planning to publish “Guidelines for the Prevention and Treatment of Infective Endocarditis.” In November 2002 the head of the National Cardiovascular Center, Dr. Kunio Miyatake, sent a questionnaire on IE to the Japanese Society of Oral and Maxillo-facial Surgeons. We obtained the cooperation of the Society's specialists and proceeded with the investigation. The results of the questionnaire, indicated that awareness of the need to prevent IE was highest postoperatively for patients with valvular disease or inoperable valvular disease, and postoperatively for congenital heart disease or inoperable congenital heart disease. Awareness of the need to prevent IE was also strong among oral surgeons treating patients who had had heart operations such as coronary artery bypass surgery and pacemaker implantation. Moreover, respondents to the questionnaire believed it was important to consider the degree of invasiveness of the specific dental treatment in patients with cardiac disease, and schemes for the prophylaxis of IE were implemented when the degree of invasiveness exceeded that of scaling. As for the antimicrobial agents given for prophylaxis, many different penicillins and cephalosporins were used. Many responses regarding dosage referred to the recommendations of the American Heart Association (AHA).

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