Antibiotic prophylaxis for dental procedures to prevent indwelling venous catheter-related infections.
BACKGROUND
chronic indwelling central venous catheters are used commonly for a variety of indications. A predominant limitation of their use is catheter-related infections. Some clinicians believe that bacteremia from an invasive dental procedure could cause catheter-related infections and that antibiotic prophylaxis may prevent this complication. The topic is controversial, in large part because of the lack of clinical trial data supporting this notion.


METHODS
we performed a systematic review to determine the level of evidence to support this practice. We retrieved studies, guidelines, recommendations, case reports, and editorials on prescribing prophylactic antibiotic therapy for indwelling central venous catheters before oral/dental procedures, using a search of PubMed, National Guideline Clearinghouse, and textbooks.


RESULTS
there were no clinical trials and no documented cases of a catheter-related infection associated with an invasive dental procedure. Despite the lack of evidence, there are numerous recommendations and guidelines available in the literature that support the administration of "dental" prophylaxis.


CONCLUSIONS
there is no evidence to support the administration of prophylactic antibiotics to prevent catheter-related infections associated with an invasive oral procedure in patients with chronic indwelling central venous catheters.
Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA. catherine.hong@carolinas.org
Catherine Hsu Ling
CH
Hong
Ryan
R
Allred
Joel J
JJ
Napenas
Michael T
MT
Brennan
Larry M
LM
Baddour
Peter B
PB
Lockhart
D019072:Antibiotic Prophylaxis; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007239:Infections / Q000209:etiology*; D019647:Oral Surgical Procedures / Q000009:adverse effects*