常规抗生素预防和早期植入失败:有没有联系?
Mojtaba Mehrabanian1, Hassan Mivehchi2, Mojtaba Dorri3
1General Dental Practitioners, Dingwall, Scotland. m.mehrabanian@gmail.com.
Evidence-based dentistry
|November 11, 2024
概括
常规抗生素预防不能显著减少健康患者早期牙植入物失败. 益处有限,抗生素耐药性增加,建议避免在牙科植入体手术中常规使用抗生素.
科学领域:
- 牙科植入物学 牙科植入物学
- 基于证据的牙科.
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗生素预防通常用于牙科植入物手术.
- 人们对抗生素耐药性的发展以及常规预防的实际益处存在担忧.
研究的目的:
- 系统地评估抗生素预防的有效性,以预防系统健康个体的早期牙植入物失败.
主要方法:
- 对随机对照试验 (RCT) 进行了全面的系统审查和元分析.
- 搜索包括主要数据库和临床试验登记册,截至2023年10月.
- 科克兰偏差风险工具 (RoB-2) 和GRADE框架用于质量评估.
主要成果:
- 分析了7项涉及1859名参与者和3014个植入物的RCT.
- 在抗生素预防中没有观察到早期牙植入失败的统计显著减少 (RR: 0.66,95% CI: 0.30-1.47).
- 预防一次失效所需治疗 (NNT) 的数量为143,表明临床影响最小.
结论:
- 常规的抗生素预防在预防医疗适合患者的早期植入失败方面没有显著的好处.
- 增加抗生素耐药性的潜力超过了证明的有限益处.
- 建议避免在牙科植入物手术中常规使用抗生素.
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