Antibiotics prescribed by dentists linked to deadly infection

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antibiotics prescribed by dentists

Antibiotics prescribed by dentists can put patients at risk for developing a serious and potentially deadly infection that causes severe diarrhoea, according to US research presented at IDWeek 2017 earlier this month

The Minnesota Department of Health (MDH) tracked community-associated Clostridium difficile (C. diff) infections—meaning in those patients who did not have an overnight stay in a hospital or nursing home—in five counties in the state over a six-year period.

During this time, researchers determined 15 per cent of those with the infection who had taken antibiotics had them prescribed for dental procedures.

But one-third of those patients’ medical charts included no mention of receiving dental procedure-related antibiotics.

An earlier survey conducted by the MDH found 36 per cent of dentists prescribed antibiotics in situations that are generally not recommended by the American Dental Association (ADA) and reported challenges to making appropriate antibiotic prescribing decisions, including confusion about or perceived conflicts among prescribing guidelines.

“Dentists have been overlooked as a source of antibiotic prescribing, which can potentially delay treatment when doctors are trying to determine what is causing a patient’s illness,” lead author of the study Dr Stacy Holzbauer said.

“It’s important to educate dentists about the potential complications of antibiotic prescribing, including C. diff. Dentists write more than 24.5 million prescriptions for antibiotics a year. It is essential that they be included in efforts to improve antibiotic prescribing.”

Dentists appropriately prescribe antibiotics in certain situations, such as to treat infections stemming from a tooth abscess. However, some dentists prescribe antibiotics prophylactically before a dental procedure to prevent a heart infection in patients with heart conditions, or to prevent an infection of an artificial joint, such as a hip or knee replacement.

The ADA no longer recommends preventive antibiotics in most of those cases, as it once did.

“It is possible some dentists aren’t aware of the updated recommendations or are being asked by other healthcare providers to continue preventive antibiotics despite the change,” Dr Holzbauer said.

Current recommendations note the risk of taking antibiotics—such as developing C. diff—is greater than the risk of an infection in those cases. Further, the inappropriate use of antibiotics helps fuel the creation of drug-resistant bacteria, which are very difficult to treat and are an increasing public health threat.

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