Dentists Continue to Overprescribe Antibiotics

Dentists make up approximately 10% of all outpatient antibiotic prescriptions in the United States, a statistic that many say is too high. The “just in case” approach to prescribing antibiotics after dental procedures is not in line with antibiotic stewardship, according to the US Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA).

The overprescribing of antibiotics has made them less effective while also creating “super bugs” that do not respond to antibiotics at all. Hence, a public health directive has been initiated to curb unnecessary antibiotic prescriptions. Dentists are targets of this endeavor due to their historically high rates of antibiotic prescriptions.

The CDC recently released “Antibiotic Stewardship Strategies: Outpatient Dental Settings”. The document advises dentists to create an antibiotic stewardship program in their offices, utilize standardized practices for antibiotic prescriptions, monitor antibiotic prescription patterns, focus on antibiotics with the greatest impact, and further larger efforts to promote antibiotic stewardship.

In turn, the ADA recently published a new clinical practice statement, “Antibiotic Stewardship: Balancing Patient Care and Public Health” in the Journal of the American Dental Association. The ADA guidelines recommend that antibiotics be prescribed only in instances of systemic involvement or active infection. Conditions that are localized, such as symptomatic irreversible pulpitis, symptomatic apical periodontitis or localized acute or chronic apical abscesses in immunocompetent adults should be addressed by pulpotomy, pulpectomy, root canal treatment, incision and drainage, or extraction.

The ADA is currently working on clinical guidelines regarding antibiotic prophylaxis for dental implant therapy. Click here to read more.