Unnecessary Dental Antibiotics Causing an Increase In C. Diff Infections

At IDWeek 2017 medical professionals shared an important warning: too many dentists are overprescribing antibiotics, to disastrous effect. When antibiotics are prescribed too freely, they can lead to the spread of antibiotic-resistant “superbugs” such as C. diff. or MRSA.

A recent study conducted by the Minnesota Department of Health (MDH) tracked community-associated Clostridium difficile (C. diff) infections across five counties in Minnesota. During the six years of research, it was determined that 15% of those with the infection had taken antibiotics that were prescribed for dental procedures.

Dental procedures are extremely common, with an outpatient wisdom teeth procedure being performed on 5 million Americans every year. Antibiotics are given if an infection begins after a procedure is completed. But this research found that 36% of dentists prescribed antibiotics for situations that are not generally recommended by the American Dental Association (ADA). These dentists also reported challenges with making appropriate antibiotic prescribing decisions, which included confusion about prescription guidelines.

“It’s important to educate dentists about the potential complications of antibiotic prescribing, including C. diff. Dentists write more than 24.5 million prescriptions for antibiotics a year. It is essential that they be included in efforts to improve antibiotic prescribing,” said Stacy Holzbauer, DVM, MPH, lead author of the study and career epidemiology field officer for the CDC and MDH.

In most cases, dentists correctly prescribe necessary antibiotics. However, some dentists choose to prescribe antibiotics as a preventative measure before a dental procedure. The ADA does not recommend preventative antibiotics, although it once did. Current ADA recommendations note that the risk of taking antibiotics is greater than the risk of infection. The misuse of antibiotics can create drug-resistant bacteria, which are very difficult to treat and are an increasing public health risk.

Between 2009 and 2015, MDH researchers looked at 1,626 people with community-associated C. diff. Of those participants, 57% reported that had been prescribed antibiotics and 15% of those being for dental procedures.

It was also found that those who were prescribed antibiotics for dental procedures were older and more likely to receive clindamycin, which is an antibiotic that’s now associated with C. diff. Additionally, 34% of those who had received antibiotics had no mention of antibiotics in their medical chart.

This further shows the disconnect between dental and medical care. It is recommended that patients bring up any past dental visits and medications, especially antibiotics, and healthcare providers should be asking patients about recent dental visits and medications.

C. diff is caused by antibiotics killing bad and good bacteria in the gastrointestinal system, allowing for the growth of C. diff bacteria. C. diff is one of the leading antibiotic-resistant threats — according to the U.S. Centers for Disease Control and Prevention, it caused almost half a million infections and led to 15,000 deaths in just one year.

However, according to research, by reducing outpatient antibiotic prescriptions by just 10%, C. diff rates could decrease by 17%.

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