Antibiotic prophylaxis for children with sickle cell disease: A survey of pediatric dentistry residency program directors and pediatric hematologists

Anupama Rao Tate, Chelita Kaye Norris, Caterina P. Minniti

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purposes: The purposes of this study were to: (1) investigate the current clinical practice regarding the use of antibiotic prophylaxis by pediatric dentistry residency program directors and pediatric hematologists for children with sickle cell disease (SCD) requiring dental treatment; and (2) evaluate the perceived relative risk of bacteremia following specific dental procedures, as defined by pediatric dentistry residency program directors and pediatric hematologists. Methods: A written survey depicting various clinical scenarios of SCD children requiring common dental procedures was mailed to directors of pediatric dental advanced education programs and distributed to pediatric hematologists attending the 2003 Annual Sickle Cell Disease Association of America conference in Washington, DC. Results: Surveys were returned by 60% (N=34/57) of the pediatric dentistry residency program directors. The surveys were obtained from 51% of pediatric hematologists at the meeting (N=72/140). At least 50% of all respondents recommended prophylaxis for the following clinical situations: dental extractions, treatment under general anesthesia, and status post splenectomy. The perceived risk of infectious complication was highest for extractions, followed by restorative treatment and tooth polishing. Dental residency program directors were more likely (71%, N=24/34) to recommend additional antibiotic therapy for patients taking penicillin prophylaxis if they required an invasive oral surgical procedure. Conversely, only 38%.(N=25/66) of pediatric hematologists recommended additional antibiotic therapy (P=.001). Eighty-six percent of dental residency program directors (N=25/29) chose amoxicillin for prophylaxis whereas only 62% of pediatric hematologists (N=36/58) recommended amoxicillin. (P<.05). Conclusions: There is a lack of consensus on the appropriate use of antibiotic prophylaxis in SCD children undergoing dental treatments. Further research and risk/benefit assessment is needed to create a unified approach.

Original languageEnglish (US)
Pages (from-to)332-335
Number of pages4
JournalPediatric Dentistry
Volume28
Issue number4
StatePublished - 2006
Externally publishedYes

Fingerprint

Pediatric Dentistry
Antibiotic Prophylaxis
Sickle Cell Anemia
Internship and Residency
Pediatrics
Tooth
Amoxicillin
Therapeutics
Oral Surgical Procedures
Anti-Bacterial Agents
Dental Education
Tooth Extraction
Splenectomy
Bacteremia
Surveys and Questionnaires
Penicillins
General Anesthesia
Research

Keywords

  • Antibiotic prophylaxis regimen
  • Dental treatment
  • Sickle cell disease

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Antibiotic prophylaxis for children with sickle cell disease : A survey of pediatric dentistry residency program directors and pediatric hematologists. / Tate, Anupama Rao; Norris, Chelita Kaye; Minniti, Caterina P.

In: Pediatric Dentistry, Vol. 28, No. 4, 2006, p. 332-335.

Research output: Contribution to journalArticle

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abstract = "Purposes: The purposes of this study were to: (1) investigate the current clinical practice regarding the use of antibiotic prophylaxis by pediatric dentistry residency program directors and pediatric hematologists for children with sickle cell disease (SCD) requiring dental treatment; and (2) evaluate the perceived relative risk of bacteremia following specific dental procedures, as defined by pediatric dentistry residency program directors and pediatric hematologists. Methods: A written survey depicting various clinical scenarios of SCD children requiring common dental procedures was mailed to directors of pediatric dental advanced education programs and distributed to pediatric hematologists attending the 2003 Annual Sickle Cell Disease Association of America conference in Washington, DC. Results: Surveys were returned by 60{\%} (N=34/57) of the pediatric dentistry residency program directors. The surveys were obtained from 51{\%} of pediatric hematologists at the meeting (N=72/140). At least 50{\%} of all respondents recommended prophylaxis for the following clinical situations: dental extractions, treatment under general anesthesia, and status post splenectomy. The perceived risk of infectious complication was highest for extractions, followed by restorative treatment and tooth polishing. Dental residency program directors were more likely (71{\%}, N=24/34) to recommend additional antibiotic therapy for patients taking penicillin prophylaxis if they required an invasive oral surgical procedure. Conversely, only 38{\%}.(N=25/66) of pediatric hematologists recommended additional antibiotic therapy (P=.001). Eighty-six percent of dental residency program directors (N=25/29) chose amoxicillin for prophylaxis whereas only 62{\%} of pediatric hematologists (N=36/58) recommended amoxicillin. (P<.05). Conclusions: There is a lack of consensus on the appropriate use of antibiotic prophylaxis in SCD children undergoing dental treatments. Further research and risk/benefit assessment is needed to create a unified approach.",
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