JAC Advance Access originally published online on May 5, 2004
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Journal of Antimicrobial Chemotherapy 2004 54(1):278; doi:10.1093/jac/dkh253
JAC vol.54 no.1 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.
Correspondence |
Comment on: Antibiotic prophylaxis, body piercing and infective endocarditis
Department of Medical Microbiology, Poole Hospital NHS Trust, Longfleet Road, Poole, Dorset, UK
Keywords: antibiotic prophylaxis , body piercing , infective endocarditis
Sir,
The recent leading article by Millar & Moore1 reviewed the seemingly growing problem of infective endocarditis following body piercing usually involving persons with underlying cardiac conditions. One aspect of the cases was not discussed, relevant to the likely effectiveness of antibiotic prophylaxis, which was in how many of the published cases was a local infection of the pierced part of the body a preceding factor. Single-dose antibiotic prophylaxis prior to the procedure is intended to prevent a transient bacteraemia related to the piercing from developing into an established endocarditis. If a bacteraemia occurs later, related to a local infection, clearly the prophylaxis will have no effect. In addition to considering antibiotic prophylaxis, it may be more valuable to ensure persons with underlying cardiac conditions are aware of the need to seek prompt treatment for any local infection that develops after body piercing. Physicians must be aware of the need to prescribe effective antibiotic therapy and to follow such cases to ensure a satisfactory resolution. This approach would be compatible with guidance given for persons with orthopaedic prosthetic devices who develop infections at other sites.2
Footnotes
* Tel: +44-1202-675771; Fax: +44-1202-665780; Email: simon.hill{at}poole.nhs.uk
References
1
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Millar, B. C. & Moore, J. E. (2004). Antibiotic prophylaxis, body piercing and infective endocarditis. Journal of Antimicrobial Chemotherapy 53, 123–6.
2 . Simmons, N. A., Ball, A. P., Cawson, R. A. et al. (1992). Case against antibiotic prophylaxis for dental treatment of patients with joint prostheses. Lancet 339, 301.[Web of Science][Medline]
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