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Meta-Analysis
. 2025 Sep;26(3):141-143.
doi: 10.1038/s41432-025-01185-w. Epub 2025 Aug 28.

Matters of the heart; antibiotic prophylaxis for prevention of infective endocarditis-are we getting it right?

Affiliations
Meta-Analysis

Matters of the heart; antibiotic prophylaxis for prevention of infective endocarditis-are we getting it right?

VSports - Rosie Fletcher et al. Evid Based Dent. 2025 Sep.

Abstract (VSports)

A commentary on: Sperotto F, France K, Gobbo M et al. Antibiotic prophylaxis and infective endocarditis incidence following invasive dental procedures: a systematic review and meta-analysis. JAMA Cardiol 2024; 9:599 VSports手机版. https://doi. org/10. 1001/jamacardio. 2024. 0873 . .

Objectives: This systematic review evaluates the association between antibiotic prophylaxis (AP) and the incidence of infective endocarditis (IE) following invasive dental procedures (IDPs) V体育安卓版. .

Materials and methods: A systematic search was conducted across PubMed, Cochrane-CENTRAL, Scopus, Web of Science, Proquest, and Embase, from inception to May 2023 V体育ios版. Observational studies, including case-control, case-crossover, cohort, self-controlled case-series, and time-trend studies were included. Data were extracted independently, and structured tools were used to evaluate study quality. A random-effects meta-analysis estimated the pooled-relative risk (RR) of developing IE in high-risk subjects who received AP compared to those who did not. .

Results: Of 11,217 identified records, 30 studies met inclusion criteria, comprising 1,152,345 IE cases. Among 12 relevant studies, five found a significant protective effect of AP in high-risk subjects. Four studies were combined in meta-analysis and showed AP was associated with a significantly lower IE risk in high-risk individuals (pooled-RR = 0. 41, 95% CI: 0. 29-0. 57). No significant association was found for moderate- or low/unknown-risk subjects. Time-trend studies showed mixed results: some indicated increased IE incidence after AP guideline changes, while others found no change or a decrease. VSports最新版本.

Conclusions: Despite limitations, this review provides an important update on AP use in preventing IE after IDPs V体育平台登录. Evidence supports AP use for high-risk individuals, while data remain inconclusive for moderate-risk populations, highlighting the need for further research. .

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Conflict of interest statement

Competing interests: The author declares no competing interests.

References

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    1. Roberts GJ. Dentists are innocent! “Everyday” bacteremia is the real culprit: a review and assessment of the evidence that dental surgical procedures are a principal cause of bacterial endocarditis in children. Pediatr Cardiol. 1999;20:317–25. 10.1007/s002469900477 - PubMed
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    1. Sperotto F, France K, Gobbo M, Bindakhil M, Pimolbutr K, Holmes H, et al. Antibiotic prophylaxis and infective endocarditis incidence following invasive dental procedures. JAMA Cardiol. 2024;9:599 10.1001/jamacardio.2024.0873 - PMC - PubMed
    1. NICE. Prophylaxis against infective endocarditis. Antimicrobial prophylaxis against infective endocarditis in adults and children. Natl Inst Clin Excell Guidel. 2008;64:1–107.

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