The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 18 , ISSUE 7 ( July, 2017 ) > List of Articles

RESEARCH ARTICLE

Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners

Francisco Rivera-Hidalgo, Leah S Spittle, Kathleen B Muzzin, Patricia R Campbell, Janice P DeWald

Citation Information : Rivera-Hidalgo F, Spittle LS, Muzzin KB, Campbell PR, DeWald JP. Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners. J Contemp Dent Pract 2017; 18 (7):559-566.

DOI: 10.5005/jp-journals-10024-2084

Published Online: 00-07-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

Antibiotic prophylaxis guidelines have been developed for health care and dentistry. The authors examined whether dentists were following the 2007 American Heart Association (AHA) and the 2012 American Association of Orthopaedic Surgeons (AAOS) recommendations for antibiotic prophylaxis.

Materials and methods

A survey was sent to 600 dentists in the south-central region of the United States. The survey examined dentists’ prescribing practices for patients with cardiac and prosthetic joint replacements, antibiotic regimen prescribed, confidence in their prescription decisions, and dentistry's contribution to antibiotic resistance.

Results

The response rate was 28.7% (n = 172). Dentists followed the 2007 AHA guidelines for patients with a history of infective endocarditis (95%), and cardiac valves repaired with prosthetic materials (76%) or animal/donor tissue (61%). For prosthetic joint replacement, 72% prescribed antibiotic prophylaxis within the first 2 years after placement and 58% continued to prescribe after 2 years. Amoxicillin was the most frequently prescribed antibiotic for cardiac conditions (92%) and prosthetic joint replacements (77%). No significant differences were found in relation to dentists’ gender (p = 0.75), year of graduation (p = 0.71), scope of practice (p = 0.30), and their confidence in their prescription decisions; 73% believed taking multiple doses of antibiotics leads to antibiotic resistance.

Conclusion

The majority of dentists were following the 2007 AHA guidelines. Confusion regarding the 2012 AAOS guidelines for prosthetic joint replacement was evident.

Clinical significance

Keeping current with changing antibiotic prophylaxis guidelines ensures dentists are providing the best evidence-based dentistry for their patients.

How to cite this article

Spittle LS, Muzzin KB, Campbell PR, DeWald JP, Rivera-Hidalgo F. Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners. J Contemp Dent Pract 2017;18(7):559-566.


PDF Share
  1. Odontogenic bacteremia following tooth cleaning procedures in children. Pediatr Dent 2000 Mar-Apr;22(2):96-100.
  2. Bacteremia associated with toothbrushing and dental extraction. Circulation 2008 Jun;117(24):3118-3125.
  3. Diverse and novel oral bacterial species in blood following dental procedures. J Clin Microbiol 2008 Jun;46(6):2129-2132.
  4. Bacteraemia following periodontal procedures. J Clin Periodontol 2005 Jul;32(7):708-713.
  5. Dental bacteremia in children. Pediatr Cardiol 1997 Jan-Feb;18(1):24-27.
  6. Bacteraemia caused by periodontal probing. Aust Dent J 1997 Apr;42(2):77-80.
  7. Incidence and magnitude of bacteraemia caused by flossing and by scaling and root planing. J Clin Periodontol 2013 Jan;40(1):41-52.
  8. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007 Oct;116(15):1736-1754.
  9. Antibiotic prophylaxis for bacteremia in patients with joint replacements. Rosemont (IL): AAOS Information Statement; 2009 [cited 2016 Dec 21]. Available from: http://www.pacosm.com/wp/wp-content/uploads/2015/08/Antibiotic-Prophylaxis-for-TJA-pts.-AAOS-March-2009.pdf.
  10. Antibiotic prophylaxis for dental patients with total joint replacements. J Am Dent Assoc 2003 Jul;134(7):895-899.
  11. The evidence base for the efficacy of antibiotic prophylaxis in dental practice. J Am Dent Assoc 2007 Apr;138(4):458-474.
  12. The dental treatment of patients with joint replacements: a position paper from the American Academy of Oral Medicine. J Am Dent Assoc 2010 Jun;141(6):667-671.
  13. Incidence of infective endocarditis due to viridans group Streptococci before and after the 2007 American Heart Association's prevention guideline: an extended evaluation of the Olmstead county, Minnesota, population and nationwide inpatient sample. Mayo Clin Proc 2015 Jul;90(7):874-881.
  14. Does prophylaxis prevent postdental infective endocarditis? A controlled evaluation of protective efficacy. Am J Med 1990 Feb;88(2):131-136.
  15. Estimated risk of endocarditis in adults with predisposing cardiac conditions undergoing dental procedures with or without antibiotic prophylaxis. Clin Infect Dis 2006 Jun;42(12):e102-e107.
  16. Dental procedures and subsequent prosthetic joint infections: findings from the Medicare current beneficiary survey. J Am Dent Assoc 2011 Dec;142(12):1343-1351.
  17. Dental procedures as risk factors for prosthetic hip or knee infection: a hospital-based prospective case-control study. Clin Infect Dis 2010 Jan;50(1):8-16.
  18. Dental procedures and the risk of infective endocarditis. Medicine (Baltimore) 2015 Oct;94(43):e1826.
  19. Prosthetic joint infection following invasive dental procedures and antibiotic prophylaxis in patients with hip or knee arthroplasty. Infect Control Hosp Epidemiol 2017 Feb;38(2):1-8.
  20. Antibiotic prophylaxis for dental patients with total joint replacements. American Dental Association; American Academy of Orthopaedic Surgeons. J Am Dent Assoc 1997 Jul;128(7):1004-1008.
  21. Prevention of orthopaedic implant infection in patients undergoing dental procedures. Evidence-Based Guideline and Evidence Report. Rosemont (IL): AAOS; 2012 [cited 2016 Dec 21]. Available from: http://www.ada.org/~/media/ADA/Member%20Center/FIles/PUDP_guideline.ashx.
  22. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. J Am Dent Assoc 2008 Jan;139 Suppl:3S-24S.
  23. Antibiotic prophylaxis practices in dentistry: a survey of dentists and physicians. J Can Dent Assoc 2007 Apr;73(3):245.
  24. Antibiotic prophylaxis for infective endocarditis: knowledge and implementation of American Heart Association Guidelines among dentists and dental hygienists in Alberta, Canada. J Am Dent Assoc 2015 Oct;146(10):743-750.
  25. Antibiotic prophylaxis for dental procedures at risk of causing bacteremia among post-total joint arthroplasty patients: a survey of Canadian orthopaedic surgeons and dental surgeons. J Arthroplasty 2014 Jun;29(6):1091-1097.
  26. Antibiotic prophylaxis prescribing practices of dentists in Singapore. Int Dent J 2014 Apr;64(2):108-114.
  27. Dentists' knowledge and implementation of the 2007 American Heart Association guidelines for prevention of infective endocarditis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008 Dec;106(6):e16-e19.
  28. Knowledge and practices of dentists in preventing infective endocarditis in children. Spec Care Dentist 2009 Jul-Aug;29(4):175-178.
  29. Acceptance among and impact on dental practitioners and patients of American Heart Association recommendations for antibiotic prophylaxis. J Am Dent Assoc 2013 Sep;144(9):1030-1035.
  30. Antibiotic prophylaxis in dentistry: a review and practice recommendations. J Am Dent Assoc 2000 Mar;131(3):366-374.
  31. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: evidence-based clinical practice guideline for dental practitioners – a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2015 Jan;146(1):11.e8-16.e8.
  32. Current concepts review prophylactic use of antibiotics for procedures after total joint replacement. J Bone Joint Surg Am 1996 Nov;78(11):1755-1770.
  33. Prophylactic antibiotics in hip and knee arthroplasty. J Bone Joint Surg Am 2009 Oct;91(10):2480-2490.
  34. Lasers and the treatment of chronic periodontitis. Dent Clin North Am 2010 Jan;54(1):35-53.
  35. A survey of antibiotic use in dentistry. J Am Dent Assoc 2000 Nov;131(11):1600-1609.
  36. Physician and dentist compliance with American Heart Association guidelines for prevention of bacterial endocarditis. J Am Dent Assoc 1989 Feb;118(2):169-173.
  37. Antibiotic prescribing by dentists has increased: why? J Am Dent Assoc 2016 May;147(5):320-327.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.