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Bacteremia in Patients Undergoing Oral ProceduresStudy Following Parenteral Antimicrobial Prophylaxis as Recommended by the American Heart Association, 1977
Aldona L. Baltch, MD;
Howard L. Pressman, DDS;
Charlene Schaffer, RDH;
Raymond P. Smith, MD;
Mark C. Hammer, MS;
Mehdi Shayegani, PhD;
Phyllis Michelsen, ScD
Arch Intern Med. 1988;148(5):1084-1088.
Abstract
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• The type and rate of bacteremia following dental extractions, dental cleaning, or other dental/oral surgical procedures were studied in 124 patients with valvular heart disease following parenteral antibiotic prophylaxis (penicillin G potassium with or without streptomycin sulfate, or vancomycin hydrochloride) as recommended by the American Heart Association in 1977. Generally, under penicillin G prophylaxis with or without streptomycin, detection of bacteremia in blood culture media containing no penicillinase was low (14.7% to 16.1% at five minutes and 3.1% to 9.0% at 30 minutes after the procedure). The number and types of organisms recovered from patients who received penicillin prophylaxis alone or with streptomycin were similar. Anaerobes were recovered twice as frequently as aerobes. Polymicrobial bacteremia was rare and only one patient had streptococci detected in the blood culture. Addition of penicillinase to one blood culture medium, however, and comparing it with a similar medium without penicillinase was accompanied with a sixfold greater recovery from patients of both aerobic and anaerobic bacteria, including six patients with streptococcal bacteremia. Vancomycin prophylaxis was accompanied with bacteremia in only one patient.
(Arch Intern Med 1988;148:1084-1088)
Author Affiliations
From the Departments of Medicine (Drs Baltch, Smith, and Michelsen and Messrs Hammer and Conroy) and Dentistry (Dr Pressman and Ms Schaffer), Albany (NY) Veterans Administration (VA) Medical Center, Albany Medical College, and the Wadsworth Laboratories for Research, New York State Department of Health (Dr Shayegani), Albany.
Footnotes
Accepted for publication Dec 28, 1987.
Read before the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 30, 1986.
Reprint requests to Infectious Disease Section, VA Medical Center (111D), Albany, NY 12208 (Dr Baltch).
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