- Unnecessary dental prophylaxis can lead to serious antibiotic-related adverse events (AEs).
- Even ≤2 days of antibiotic usage can result in AEs.
Why this matters
- Dentists prescribe 10% of antibiotics annually, and this percentage has remained stable.
- 80% of prophylactic antibiotics prescribed by dentists are unnecessary.
- Antibiotics are no longer recommended in prosthetic joint replacements or with cardiac conditions, except for those at high risk for endocarditis.
- Antibiotic stewardship programs must include dentists, who may be unaware of reactions treated outside the dental setting.
- Dentists are the top prescribers of clindamycin, which is linked to increased risk for Clostridium difficile infection.
- Retrospective cohort of dental visits, 2011-2015.
- Included patients with unnecessary prophylaxis (prophylaxis in patients who did not have manipulation of the gingiva/tooth periapex or an appropriate cardiac diagnosis).
- Primary endpoint: cumulative incidence of AEs within 14 days postprescription, a composite of allergy, anaphylaxis, C difficile infection, and emergency department visit.
- Of all unnecessary prophylactic antibiotics, 3.8% were associated with AEs.
- Most frequent events were emergency department visits (1.2%) and new allergies (2.9%).
- Clindamycin was linked to more AEs than amoxicillin (322/1000 person-years; 95% CI, 238-406).
- Presented at a conference without peer review.