IDWeek: Antibiotics before dental visits are overprescribed and increase the risk of side effects

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Research presented at IDWeek (2–6 October 2019, Washington, DC, USA) has suggested that antibiotics are overprescribed before most dental visits and that these prophylactic treatments could increase the risk of serious side effects such as allergic reactions or Clostridium difficile infection.

Antibiotics are often prescribed before dental visits to prevent infections in some individuals, for example, those who have had knee replacements. Current guidelines only recommend antibiotic prophylaxis for patients who have significant risk of heart infections after invasive dental procedures, however, prescription remains common.

This study analyzed a national claims database between 2011 and 2015, determining 168,420 dental visits where preventative antibiotics were prescribed. The researchers concluded that 80% of antibiotics prescribed were unnecessary and 3.8% of these prescriptions were associated with adverse events within 14 days. These events included 3912 allergic reactions, 1568 visits to the emergency room and 9 C. difficile infections. They also determined clindamycin was associated with more adverse events than amoxicillin.

Author, Katie J. Suda (University of Illinois, IL, USA), concluded: “While the vast majority of dental patients who take preventive antibiotics will not have a severe reaction, this is a reminder that antibiotics are not innocuous, even if taken for only a day or two. Ultimately, if an antibiotic is not indicated we should try to avoid exposure to them to lessen the likelihood of patient harm.”

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Source: Gross AE, Suda KJ, Zhou J et al. SHEA featured oral abstract: serious antibiotic-related adverse effects following unnecessary dental prophylaxis in the United States. Presented at IDWeek 2019, Washington, DC, USA, 2–6 October 2019 (Abstract 1895).

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