FGDPUK)The FGDP(UK) has endorsed new advice for dentists on the use of antibiotics against infective endocarditis (IE).

New advice from the Scottish Dental Clinical Effectiveness Programme (SDCEP) says patients at increased risk of IE shouldn’t be offered prophylaxis.

However antibiotics may be considered for patients requiring special consideration after consultation with their cardiologist.

‘For over 10 years the recommendations in NICE CG64, which apply to all healthcare professionals including cardiologists, have remained the same,’ Dr Nick Palmer, editor of the FGDP(UK)’s Antimicrobial Prescribing For General Dental Practitioners, said.

‘These are that patients at increased risk of IE should be advised of the risks and benefits of prophylaxis, and that antibiotic prophylaxis is not routinely required for invasive dental procedures.

‘The patient should also be advised of the symptoms of IE, of the importance of maintaining good oral health to reduce their risk of IE, and when to seek expert advice.’

Antibiotic use

The Faculty of General Dental Practice (FGDP) has previously raised concerns over advice for antibiotic use against IE.

However, with recent improvements, the faculty has decided to endorse the new guidance.

NICE has also released advice stating that antibiotic prophylaxis is not recommended ‘routinely’ for invasive dental procedures.

‘SDCEP’s implementation advice re-emphasises the NICE CG64 recommendations, but notes that there are a very small number of dental patients that may require “special consideration” for antibiotic prophylaxis,’ Dr Palmer continues.

‘Importantly, SDCEP’s implementation advice shifts the balance of responsibility for the decision on antibiotic prophylaxis for these patients from the dentist to the patient’s cardiologist and to the patient under Montgomery consent.

‘Dentists should ensure they record in the clinical notes any advice from the patient’s cardiologist, and the patient’s consent when a decision is made.’


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