The purpose of this thread was never to question antibiotics, in fact they are necessary.
I want to know your opinions on how endocarditis is spread.
Conclusions
• The risk of IE after dental intervention is extremely low even in high-risk patients.
• The cumulative lifetime risk of IE from daily activities (chewing, tooth brushing, flossing) is much higher than that attributed to infrequent dental, respiratory, gastrointestinal, or genitourinary procedures.
• Antibiotic prophylaxis for IE in high-risk patients is a complex issue that remains unresolved, and there is broad consensus that there is little evidence from high-quality studies for or against its effectiveness and cost-benefit ratio.
• In America and most European countries, antibiotic prophylaxis is only recommended prior to invasive dental procedures in high-risk patients. However, in the United Kingdom and Japan, prophylaxis is not recommended even in high-risk patients, which is a true reflection of the existing uncertainty.
• Antibiotic prophylaxis for IE is a reasonable strategy for patients at high risk for IE or for serious adverse events with IE when undergoing high-risk dental procedures.
• Route antibiotic prophylaxis is not recommended for non-dental procedures. Antibiotic treatment is only necessary for patients at high risk for IE when performing non-dental invasive procedures in the setting of infection.
• Usually, neither the primary care physician nor the cardiologist or other specialist knows exactly what dental procedure their patient may need. Most prescriptions for antibiotic prophylaxis for IE are made by dental surgeons and dentists in the setting of defensive medicine. Education of these professionals and knowledge of clinical guidelines and patient-specific recommendations is paramount.
Mistakes to avoid
•Consider that any dental intervention carries a risk of IE.
•Consider that recommendations for or against antibiotic prophylaxis for IE come from high-quality studies and high evidence.
•Consider that all patients with cardiac pathology are high-risk patients for contracting IE.
•Do not convey to patients that the risk of contracting IE after any dental procedure, including those considered high-risk, is very low even in high-risk patients.
•Forget to take aseptic measures during the insertion and handling of venous catheters and during invasive procedures, including outpatient procedures, to reduce the rate of IE associated with diagnostic and therapeutic procedures.
Link to the article in Spanish (translate)
https://www.fmc.es/es-profilaxis-antibiotica-endocarditis-infecciosa-articulo-S1134207219300969
I have read quite a few, but this one seems very complete to me.