Antibiotska profilaksa prije stomatoloških zahvata

master's thesis

• Title (english): Antibiotic Prophylaxis Prior to Dental Procedures
• Author: Tena Križnik
• Mentor: Danica Vidović Juras (mentor)
• Committee member: Danica Vidović Juras (predsjednik povjerenstva)
• Committee member: Ana Andabak Rogulj (član povjerenstva)
• Committee member: Božana Lončar Brzak (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Medicine); Zagreb
• Defense date and country: 2021-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

U današnje doba postoji velik broj naizgled zdravih pacijenata od kojih anamnestički možemo saznati da su preboljeli ili imaju različite bolesti i poremećaje. Samim time moguće je da predstavljaju rizičnu skupinu kojoj kod invazivnih stomatoloških zahvata treba pristupiti ordiniranjem antibiotske profilakse kako bismo smanjili mogućnost pojave komplikacija. To se odnosi na oralnokirurške, parodontološke zahvate ili pak zahvate koji podrazumijevaju manipulaciju u periapikalnom području. Činjenica je da se u zemljama diljem svijeta vode polemike o tome koja su to točno stanja koja zahtijevaju preoperativno ordiniranje antibiotske profilakse u svrhu prevencije infekcije, odnosno koja to ne zahtijevaju. Često je neusuglašen i stav o potrebnom režimu antibiotske profilakse. Pregledom relevantne literature moguće je pronaći relativno definirane smjernice za kardiovaskularna stanja s rizikom pojave infektivnog endokarditisa, za HIV pozitivne pacijente u uznapredovaloj fazi bolesti i općenito sa znakovima neutropenije te za pacijente s nereguliranim dijabetesom i oni svakako preoperativno zahtijevaju antibiotsku profilaksu. Kod pacijenata s umjetnim zglobovima i reguliranim dijabetesom nije potrebno propisati antibiotsku profilaksu. Pacijenti na dijalizi nisu pod velikim rizikom od infekcije pa rutinsko propisivanje profilakse nije potrebno. Kod pacijenata s transplantiranim organima ne postoje striktno propisani protokoli za propisivanje antibiotske profilakse u prijeoperativnom i postoperativnom razdoblju. Propisivanje profilakse kod pacijenata s rizikom pojave osteonekroze čeljusti, odnosno pacijenata zračenih u području glave i vrata te pacijenata na antiangiogenim i antiresorptivnim lijekovima, predmet je najveće diskusije, a protokol propisivanja antibiotika razlikuje se među klinikama i terapeutima.

Abstract (english)

Nowadays, there is a large number of seemingly healthy patients from whom we can anamnestically learn that they have recovered or have various diseases and disorders. Therefore, it is possible that they represent a risk group that should be approached by prescribing antibiotic prophylaxis in invasive dental procedures in order to reduce the possibility of complications. This refers to oral surgery, periodontal procedures or procedures that involve manipulation of the periapical area. Around the world, there is a lot of discussion on exact conditions that require preoperative administration of antibiotic prophylaxis in order to prevent infection and which conditions do not require it. After reviewing the literature, it is clear that there are currently defined relative guidelines for cardiovascular conditions with a risk of infective endocarditis, HIV-positive patients living with advanced disease and conditions with general signs of neutropenia, and patients with unregulated diabetes that certainly require antibiotic prophylaxis preoperatively. Antibiotic prophylaxis is not required in patients with artificial joints and regulated diabetes. Patients who undergo dialysis treatment are not at high risk of infection, so
routine prophylaxis is not necessary. There are no strictly prescribed protocols for prescribing antibiotic prophylaxis in the preoperative and postoperative period in organ transplant patients. Prescribing prophylaxis in patients at risk of osteonecrosis of the jaw, i.e. patients who received radiation treatment in the head and neck area and patients on antiresorptive agents and antiangiogenesis drugs is the main subject of discussions, and the protocol for prescribing
antibiotics differs from clinics and medical professionals.

• Keywords: antibiotska profilaksa; stomatologija; endokarditis; dijabetes; HIV
• Keywords (english): Antibiotic Prophylaxis; Dentistry; Endocarditis; Diabetes Mellitus
• Language: croatian
• URN:NBN: urn:nbn:hr:127:353539
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-08-27 09:22:26