Hassan Abed

Background The spleen is a multi‐functional organ that supports the immune system and is involved in the production of platelets and red blood cells. People with splenic dysfunctions or asplenia are predisposed to infection; hence, adults with splenic dysfunction, splenectomy or congenital asplenia may require antibiotic prophylaxis prior to dental procedures to prevent possible bacteraemia which could be caused by dental extraction. Aims To assess the current evidence to determine whether adults with splenic dysfunction, splenectomy or congenital asplenia require antibiotic prophylaxis prior to dental extraction. Materials and Methods A systematic review following the Preferred Reporting Item for Systematic Review and Meta‐analyses (PRISMA) guidelines (registration number: CRD42021230933) was conducted using Ovid MEDLINE and EMBASE databases. PROSPERO was searched for ongoing or recently completed systematic reviews and The ClinicalTrials.gov was searched for ongoing or recently completed trials. The evidence of all articles was evaluated based on the Oxford Level of Evidence. The Grading of Recommendations Assessment, Development and Evaluation approach was used to summarise the evidence. Results Nine articles published from 1984 to 2016 were included in the data synthesis and analysis. The included articles presented level 5 evidence; hence, all were identified at level D of the recommendation. Conclusions Antibiotic prophylaxis should not be routinely prescribed for adults with splenic dysfunctions, splenectomy or congenital asplenia prior to dental extraction as sepsis post‐dental extraction in this group of patients is very rare.