Most preventive antibiotics prescribed by dentists are unnecessary

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Scientists from the University of Illinois at Chicago found that 81% of antibiotics prescribed by dentists to prevent infections prior to dental visits are unnecessary.

This surprising finding highlights the need for improved antibiotic stewardship in dental practices, especially those located in the Western U.S.

The research is published in JAMA Network Open and was conducted by Katie Suda et al.

In the study, the team used a national integrated health claims database to analyze dental visits occurring between 2011 and 2015.

They compared antibiotic prescriptions—which were dispensed prior to 168,420 dental visits—to the number of high-risk cardiac patients who, per national guidelines, are the only patients recommended for antibiotics prior to a dental procedure.

They found that 81% of prescriptions did not align with the national guidelines and were provided for patients without high-risk cardiac conditions.

The team says the use of preventive antibiotics in these patients opens them up to the risks associated with antibiotic use—increasing bacterial resistance and infections, for example.

The researchers also looked at dentists’ antibiotic prescribing patterns by geography. They found that the Western U.S. and urban areas were more likely to have unnecessary prescribing.

Among patients most likely to fill prescriptions for unnecessary antibiotics are those with prosthetic joint implants and those receiving clindamycin.

These results point to trends by geography that is unexpected and to an alarming tendency of dental providers to select clindamycin, which is associated with a higher risk of developing C. difficile infections when compared to some other antibiotics.

The team says dental providers should view this study, which is the first to look at preventive antibiotic prescribing for dental procedures and provide this type of actionable information, as a powerful call to action, not a rebuke.

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