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Dentists Take Heat for Antibiotic-Linked C. diff

News  |  By Alexandra Wilson Pecci  
   October 09, 2017

A study links dental antibiotic prescribing with C. diff infection, and often, unnecessary prescriptions.

Efforts have been made to curb the use of unnecessary antibiotic prescribing among many healthcare specialties, but one seems to be out of the loop: Dentists.

New research presented at IDWeek 2017 suggests that antibiotics prescribed by dentists may contribute to Clostridium difficile (C. diff) infections, which are often linked to antibiotic use.

Furthermore, many of the antibiotics they prescribed were likely unnecessary, the researchers said.

"Dentists have been overlooked as a source of antibiotic prescribing," Stacy Holzbauer, DVM, MPH, lead author of the study and career epidemiology field officer for the CDC and Minnesota Department of Health (MDH), said in a statement.

  • MDH researchers interviewed 1,626 people with community-associated C. diff between 2009 and 2015.
  • Of those, 57% reported they had been prescribed antibiotics; 15% of those were for dental procedures.
  • Those who were prescribed antibiotics for dental procedures tended to be older and more likely to receive clindamycin, an antibiotic that is associated with C. diff infection.
  • Other research in the Journal of the American Dental Association suggested that “dentists and dental specialists are significant contributors to outpatient antibiotic prescriptions in the United States.”
  • The JADA study found that in 2015, “As a group, general dentists and dental specialists were responsible for more than 2.9 million antibiotic prescriptions, higher than levels for several other medical and allied health care provider specialties.”
  • An earlier MDH survey found 36% of dentists prescribed antibiotics in situations that are generally not recommended by the American Dental Association.
  • That tracks with the trend overall: At least 30% of antibiotics prescribed in the United States are unnecessary, research shows.
  • C. diff isn’t the only thing to worry about: JAMA Internal Medicine research showed that 20% of hospitalized patients who received at least 24 hours of antibiotic therapy developed antibiotic-associated adverse drug events, such as gastrointestinal, kidney, and blood abnormalities.
  • The new MDH study also highlights the disconnect between doctors and dentists. Of those patients who had received antibiotics for a dental procedure, 34% had no mention of antibiotics in their medical charts.
  • There has long been a divide between dental and medical care, and experts agree that further collaboration is needed between the two.

Alexandra Wilson Pecci is an editor for HealthLeaders.


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