Rochester, MN—Before 2007, the American Heart Association (AHA) guidelines recommended prophylactic antibiotics for all dental patients with cardiac conditions who were at moderate or high risk of developing infective endocarditis.

Since then, the recommendation has changed, and antibiotics are urged only for high-risk cardiac patients.

A study published online in Mayo Clinic Proceedings looks at how well dentists and oral surgeons are complying with the revised guidelines.

In the first study to review dental records in the Rochester Epidemiology Project, Mayo Clinic researchers found that compliance with the change in prophylactic antibiotic use has been good in their area.

The project is a collaboration of medical and dental care providers in Minnesota and Wisconsin, and researchers had access to combined records for research purposes.

Earlier studies by lead author Daniel DeSimone, MD, determined no increases in the incidence of infective endocarditis in Olmsted County, MN, before and after 2007, using Rochester Epidemiology Project data. Then, however, “the major limitation of these studies was the lack of access to dental records,” he said.

“The inclusion of dental records in the Rochester Epidemiology Project provides a unique opportunity unlike any population health database in the United States,” Simone pointed out. “The primary criticism of the earlier studies was, ‘Are dentists actually following the 2007 AHA guidelines, or do patients continue to receive antibiotics when no longer indicated?’ How could we prove that dentists were actually following the guidelines, rather than assuming they were? Now we can.”

DeSimone pointed to the risk of increased bacterial resistance with unnecessary use of antibiotics, as well as the greater costs to patients, which—although only a few dollars a year—could add up to more than $100 million a year for moderate-risk cardiac patients purchasing the drugs.

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