Article type
Abstract
Background
Antimicrobial resistance is a global and complex problem requiring the coordination of multiple actions and agents. This is one of the priorities of the Spanish National Action Plan on Antimicrobial Resistance (PRAN).
In this context, the current Antimicrobial Therapeutic Guideline (ATG) is being updated to incorporate new evidence and new clinical conditions. This communication describes the updating process of ATG chapters on the usage of antibiotics as treatment or prophylaxis for oral and odontogenic diseases in the community.
Objectives
To describe the methodology used to update recommendations and incorporate new clinical conditions related to the management of oral and odontogenic infections applying the GRADE adolopment approach
Methods
A panel of experts composed by physicians, pharmacists, microbiologists and methodologists developed the PICO questions and selected the main outcomes.
Following the GRADE adolopment approach, we reviewed the evidence available to answer 16 clinical questions included in the original guideline and 6 questions developed de novo.
Specific search strategies were designed and applied to retrieve evidence in databases MedLine, Embase, Web of Science, CINAHL and Cochrane Library. Additionally, several data sources of guidelines were checked. COVIDENCE software was used to select and review the studies that met the selection criteria. Evidence profiles and Evidence to Decision frameworks were developed with GRADEpro software.
Results
Twenty-two questions about the managing of antibiotics in odontogenic and oral diseases were addressed.
32 recommendations were reviewed, including 18 recommendations about odontogenic diseases to answer 15 questions, and 8 recommendations on five questions about non-odontogenic oral infections. Additionally, two recommendations to answer two questions about prophylaxis of infective endocarditis in patients undergoing dental procedures were reviewed.
Most of the questions were related to antibiotic treatment, and three questions to the use of antibiotic in prophylaxis.
Conclusions
The update of recommendations on odontogenic and no odontogenic oral diseases has been a complex process mainly due to the heterogeneity of the research questions and the challenge of upgrading the methodology applied in the original guideline to the GRADE methodology. The development of a methodological guide allowed us to standardize the procedure for the updating and de novo development of recommendations.
Antimicrobial resistance is a global and complex problem requiring the coordination of multiple actions and agents. This is one of the priorities of the Spanish National Action Plan on Antimicrobial Resistance (PRAN).
In this context, the current Antimicrobial Therapeutic Guideline (ATG) is being updated to incorporate new evidence and new clinical conditions. This communication describes the updating process of ATG chapters on the usage of antibiotics as treatment or prophylaxis for oral and odontogenic diseases in the community.
Objectives
To describe the methodology used to update recommendations and incorporate new clinical conditions related to the management of oral and odontogenic infections applying the GRADE adolopment approach
Methods
A panel of experts composed by physicians, pharmacists, microbiologists and methodologists developed the PICO questions and selected the main outcomes.
Following the GRADE adolopment approach, we reviewed the evidence available to answer 16 clinical questions included in the original guideline and 6 questions developed de novo.
Specific search strategies were designed and applied to retrieve evidence in databases MedLine, Embase, Web of Science, CINAHL and Cochrane Library. Additionally, several data sources of guidelines were checked. COVIDENCE software was used to select and review the studies that met the selection criteria. Evidence profiles and Evidence to Decision frameworks were developed with GRADEpro software.
Results
Twenty-two questions about the managing of antibiotics in odontogenic and oral diseases were addressed.
32 recommendations were reviewed, including 18 recommendations about odontogenic diseases to answer 15 questions, and 8 recommendations on five questions about non-odontogenic oral infections. Additionally, two recommendations to answer two questions about prophylaxis of infective endocarditis in patients undergoing dental procedures were reviewed.
Most of the questions were related to antibiotic treatment, and three questions to the use of antibiotic in prophylaxis.
Conclusions
The update of recommendations on odontogenic and no odontogenic oral diseases has been a complex process mainly due to the heterogeneity of the research questions and the challenge of upgrading the methodology applied in the original guideline to the GRADE methodology. The development of a methodological guide allowed us to standardize the procedure for the updating and de novo development of recommendations.