Antibiotic Prophylaxis in Immunocompromised Patients

Individuals with complex medical conditions and disability demonstrate poorer oral health and oral healthcare outcomes.68-70 Therefore, they may be more likely to require invasive surgical dental procedures, such as tooth extractions and periodontal surgery. Recent investigations have demonstrated that in medically compromised patients in whom their systemic conditions are well controlled, routine dental extractions of non-infected teeth can be performed without antibiotics with low levels of post-operative infections and complications.71,72 However, in other conditions where risk of infection cannot be mitigated or when the outcomes of infection may convey serious oral and/or systemic health risks to patients, the use of antibiotic prophylaxis prior to dental surgical procedures may be warranted.73,74 Additionally, in cases where pre-existing infection at tooth sites is present, antibiotic prophylaxis may be advantageous to reduce post-operative complications.75 Ultimately, the decision to prescribe antibiotic prophylaxis is, in most cases, empirical and it is imperative that dental healthcare providers thoroughly evaluate patient-, site-, and procedure-related risks to determine the overall risk-benefit of antibiotic prophylaxis for individual cases.

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