Dental Antibiotic Prescriptions Linked to Clostridium difficile

Dental Antibiotic Prescriptions Linked to Clostridium difficile

During a

presentation at the Infectious Diseases Week 2017 conference in San Diego, the

Minnesota Department of Health (MDH) reported that dentist-prescribed

antibiotics are likely responsible for a growing number of Clostridium difficile infections—and that many of these

prescriptions may be unnecessary. Between 2009 and 2015, MDH researchers interviewed

1,626 individuals with community-associated C.

difficile (ie, infections in patients who did not have an overnight

stay in a hospital or nursing home). They determined that 136 (or 15%) of these

individuals had taken antibiotics prescribed for dental procedures. However, of

those who had received antibiotics for dental treatment, 34% had no notation of

antibiotics in their medical charts.

To

improve interdisciplinary communication between health professionals and

patients, Stacy Holzbauer, DVM, MPH, lead researcher and an epidemiology field

officer for the United States Centers for Disease Control and Prevention and

MDH, recommends that patients mention dental visits and medications they have

taken to their medical providers. In addition, oral health professionals should

continue to inquire about patients’ medical records and prescription history.

In

a previous survey, MDH researchers found that 36% of dentists prescribed

antibiotics in situations generally not recommended by the American Dental

Association (ADA), including prophylactic prescriptions for patients with heart

conditions and/or prosthetic joints. Updated 2015 ADA guidelines recommend

antibiotic prophylaxis in only a small number of patients with heart conditions

or joint replacements. In addition, the guidelines suggest that for patients with

a history of complications associated with joint replacement surgery who are undergoing dental procedures that include gingival

manipulation or mucosal incision, prophylactic antibiotics should only be

considered after consultation with the patient and orthopedic surgeon. For this

reason, it is imperative for oral health professionals to stay abreast of current

recommendations, and judiciously consider when antibiotic prescriptions are

appropriate. 

Hygiene Connection E-Newsletter

November 2017