Researchers Report Most Dental Antibiotic Prophylaxis Prescriptions Are Unnecessary

Dentists write too many antibiotic prescriptions before procedures — 80.9%, to be exact — for patients who do not need them, according to a University of Illinois College of Pharmacy study. The findings suggest dental providers need to ramp up their antibiotic stewardship efforts.

Reporting in the paper, “Assessment of the Appropriateness of Antibiotic Prescriptions for Infection Prophylaxis Before Dental Procedures, 2011 to 2015,” published in JAMA Network Open, researchers analyzed 168,420 visits by 91,438 patients in which antibiotic prophylaxis was prescribed. The team reviewed American Heart Association and American Dental Association guidelines to determine which prescriptions were appropriate. Among these individuals, 42.5% had prosthetic devices and 20.9% had cardiac conditions associated with a high risk of endocarditis. Overall, however, investigators determined that per the guidelines only 19.1% of the antibiotic prescriptions were indicated. Among the reasons for questionable prescriptions from dental providers is that a patient’s physician may recommend it; dentists may also have concerns over possible medicolegal issues if a prescription is not offered and problems arise.

With the goal of responsible antibiotic stewardship, dentists are encouraged to consult the current recommendations for antibiotic prophylaxis. In addition, the authors noted one positive finding: Unnecessary prescribing decreased over the study period, which indicates guideline changes are being implemented in clinical care.

From Decisions in Dentistry. September 2019;5(8):8.