Antibiotics prescribed by dentists as a pre-emptive strike against infection are unnecessary 81 per cent of the time, according to a US study.
The findings—published in JAMA Network Open—are important because dentists are responsible for 10 per cent of all antibiotic prescriptions written in the United States.
Antibiotics prescribed when not warranted expose patients to the risk of side effects unnecessarily and also contribute to the problem of antibiotic resistance.
Antibiotics are recommended as a prophylactic prior to some dental procedures for patients with certain types of heart conditions.
Researchers used a national health care claims database to examine nearly 170,000 dentist-written antibiotic prescriptions from 2011 to 2015.
The prescriptions involved more than 90,000 patients, 57 per cent female, with a median age of 63.
More than 90 per cent of the patients underwent a procedure that possibly warranted taking an antibiotic ahead of time. However, less than 21 per cent 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 Jessina McGregor of Oregon State University.
The researchers also looked at the prescriptions regionally and found unnecessary prescriptions to be most prevalent, on a percentage basis, in the West; 85 per cent of the prescriptions written were out of sync with the guidelines.
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 Illinois-Chicago 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.”