81% of antibiotics prescribed by dentists are unnecessary
A new study has found that 81% of antibiotics prescribed by dentists in the USA are unnecessary, and are being prescribed as a pre-emptive measure.
The researchers associated with the study, published in JAMA Network Open, said the findings are a call to action to dentists to revisit preventative antibiotic prescribing for dental procedures.
In the US, dentists are responsible for 10% of antibiotic prescriptions; antibiotics are recommended as a prophylactic prior to some dental procedures for patients with certain heart conditions. However, unnecessary antibiotics expose patients to the risk of side effects and contribute to antibiotic resistance.
Research findings
Researchers used a national healthcare claims database to examine nearly 170,000 dentist-written antibiotic prescriptions from 2011 to 2015.
The prescriptions involved more than 90,000 patients, 57% female, with a median age of 63.
Greater than 90% of the patients underwent a procedure that possibly warranted taking an antibiotic ahead of time. However, less than 21% of those people had a cardiac condition that made an antibiotic prescription recommended under medical guidelines.
“Preventive antibiotics in these patients gave them risks that outweighed the benefits,” said researcher Jessina McGregor, Associate Professor for OSU College of Pharmacy.
Over 80% of the unnecessary prescriptions were written in urban population centres, 79% in rural areas.
Among patients who filled prescriptions for unnecessary antibiotics, clindamycin was the most common drug, and joint implants were the most typical reason they were prescribed.
“Dental providers are very thoughtful when they develop care plans for their patients and there are many factors that inform dentists’ recommendations, but this study shows that there is an opportunity for dentists to re-evaluate if necessary,” said Susan Rowan of the UIC College of Dentistry. “I think dental providers should view this study, which is the first to look at preventive antibiotic prescribing for dental procedures, as a powerful call to action, not a rebuke.”
The study was limited to patients with commercial dental insurance and the analysis used a broad definition of high-risk cardiac patients, suggesting the findings may underestimate the unnecessary prescribing of antibiotics.
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