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
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