title: Post-NICE 2008: Antibiotic prophylaxis prior to dental procedures for patients with pulmonary arteriovenous malformations (PAVMs) and hereditary haemorrhagic telangiectasia.
abstract: Recently published guidance from NICE highlights that antibiotic prophylaxis is no longer required for patients with structural heart disease at risk of infective endocarditis. The American Heart Association has published similarly less interventive guidance. Individuals with pulmonary arteriovenous malformations and hereditary haemorrhagic telangiectasia are at risk of brain abscess from dental bacteraemias. In this article we explore why these patients do not fall into the groups considered by NICE and provide recommendations to reduce their risks of dental bacteraemias, including optimising dental hygiene and use of antibiotic prophylaxis prior to dental procedures.
authors.affiliation: NHLI Cardiovascular Sciences, Imperial College London/Respiratory Medicine, Imperial College Healthcare NHS Trust, London. c.shovlin@imperial.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: Shovlin
authors.forename: K
authors.initials: K
authors.lastname: Bamford
authors.forename: D
authors.initials: D
authors.lastname: Wray
mesh_terms: D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D001165:Arteriovenous Malformations / Q000150:complications; D016470:Bacteremia / Q000517:prevention & control; D001922:Brain Abscess / Q000209:etiology / Q000517:prevention & control*; D017742:Dental Care for Chronically Ill; D004338:Drug Combinations; D006801:Humans; D017410:Practice Guidelines as Topic; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D019980:Amoxicillin-Potassium Clavulanate Combination