内心炎预防:是时候审查NICE指南了
Martin Thornhill1, Bernard Prendergast2, Mark Dayer3
1Unit of Oral & Maxillofacial Medicine, Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
The Lancet regional health. Europe
|March 14, 2024
概括
在侵入性牙科手术 (IDP) 之前的抗生素预防 (AP) 可以预防高风险患者的传染性内心炎 (IE). 新证据支持AP的说法.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 公共卫生政策 公共卫生政策
背景情况:
- 国际指导方针 (ESC,AHA) 建议对接受侵袭性牙科手术 (IDP) 的高风险患者进行抗生素预防 (AP),以预防传染性内心炎 (IE).
- 英国的NICE指南,最后一次更新于2015年,不推常规AP为境内流离失所者,在患者护理中造成差异.
- 自2015年以来,关于AP在IE预防中的有效性和安全性出现了重要的新证据.
研究的目的:
- 审查2015年以来IDP和IE之间的关联的新证据.
- 评估AP的安全性和有效性,以减少高风险个人后的IE风险.
- 评估重新引入AP的成本效益,在英国国家卫生服务的高风险患者.
主要方法:
- 审查自2015年以来出版的科学文献和临床数据.
- 对侵袭性牙科手术和传染性内心炎之间的关联进行分析.
- 评估抗生素预防的安全性,有效性和成本效益.
主要成果:
- 侵袭性牙科手术与感染性内心炎的风险增加有关.
- 抗生素预防已被证明是安全和有效的,可以减轻高风险患者的这种风险.
- 预计重新引入AP将为英国国家卫生服务提供显著的成本节约和健康益处.
结论:
- NICE应审查其2015年关于侵入性牙科手术抗生素预防的指南.
- 将英国的指导方针与国际标准 (ESC,AHA) 保持一致,将确保高风险患者获得针对传染性内心炎的一致保护.
- 实施基于证据的AP建议将改善患者的治疗结果,并可能降低医疗保健成本.
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