Antibiotics may harm ‘heart risk’ dental patients

A University of Sheffield research team is to look at whether withdrawing antibiotic cover for dental patients at risk of a serious heart infection is leading to more cases of the life-threatening illness.

The research, funded by a grant of nearly £100,000 from the charity Heart Research UK following a donation to the charity of £150,000 from healthcare provider Simplyhealth, will find out whether a guideline to end antibiotic cover for patients at risk of infective endocarditis – a serious infection of the inner lining of the heart – has led to an increase in cases.

In March 2008, the National Institute for Health and Care Excellence (NICE) suggested that antibiotic cover for dental patients at risk of this heart infection should stop.

NICE felt research studies did not support the use of antibiotics during dental treatment, and giving them also has the risk of side-effects and allergic reactions in patients, and can lead to the emergence of antibiotic-resistant bacteria, or so-called ‘superbugs’.

Now the team from Sheffield will use a full five years’ data on the prescribing of antibiotic cover by dentists and its effect on the number of cases of infective endocarditis which will give much better and more detailed evidence about the effectiveness, or not, of antibiotic cover.

The results will be of great importance to all dentists and cardiologists in the UK as well as the many at-risk patients.

It will also be of interest in other countries such as the US and the rest of Europe where guidelines still recommend that dentists give antibiotic cover to at-risk patients.

If there is still no detectable rise in the number of cases of infective endocarditis, this will give dentists, doctors and patients more confidence in the NICE guidelines. It would also suggest that improving the oral hygiene of at-risk patients might be a more effective way of preventing infective endocarditis than antibiotic cover.

 Professor Martin Thornhill, professor of translational research in dentistry at the University of Sheffield’s  School of Clinical Dentistry said that infective endocarditis can affect individuals with predisposing heart  conditions, and in up to 60% of cases the bacteria that causes this infection has entered the blood from the mouth.

Professor Thornhill said: ‘To prevent the condition it was previously the practice of dentists to give  antibiotics to patients at risk before carrying out invasive dental work. By studying if the number of cases  of infective endocarditis has gone up since the introduction of the NICE guidance, we aim to produce the  evidence to determine if giving antibiotics really is effective or not in preventing infective endocarditis.’
Clare Lee, head of brand, PR and digital at Simplyhealth said: ‘We’re very pleased that our campaign has engaged 150,000 people on Facebook and we would like to thank everyone who supported our campaign by Liking our Facebook page and who helped us turn the need for this important research study to a reality.

‘Thanks to its partnership with Simplyhealth, Heart Research UK has awarded £98,802 to the University  of Sheffield to study the link between dental health and cardiovascular disease. This piece of research  will now help us understand more about the impact that antibiotics can have for patients at risk of  infective endocarditis, which is a serious infection of the lining of the heart that affects 2,000 to 5,000  people per year in the UK. It will be the lasting legacy of our campaign.'

Barbara Harpham, national director of Heart Research UK, said: 'Our partnership with Simplyhealth has not only brought us this really valuable research project but has highlighted how important it is to look after your teeth since the remainder of Simplyhealth’s £150,000 donation will fund community initiatives which will educate schoolchildren on the importance of dental health. This added bonus means we can get messages across to schoolchildren so they develop good habits that will last them a lifetime.’

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