CDC, OSAP Issue Best Practices for Dentists Prescribing Antibiotics
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By: Lauri Hicks, DO, Director, Office of Antibiotic Stewardship, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Today, CDC, in collaboration with the Organization for Safety, Asepsis, and Prevention (OSAP), published an article in The Journal of the American Dental Association (JADA), concerning responsible antibiotic use in dentistry. Data show that primary care dentists – not including dental specialists or surgeons – write approximately 10 percent of all antibiotic prescriptions filled in outpatient pharmacies each year. That equates to nearly 26 million prescriptions.
With data showing that 30 percent of all outpatient antibiotic prescriptions are unnecessary, it’s crucial that healthcare providers across all specialties commit to improving antibiotic prescribing in their individual practice settings. Due to barriers in data collection, it is unclear exactly how much unnecessary antibiotic prescribing takes place in dentistry. However, there is concern that unnecessary and inappropriate prescribing is common in dental offices.
In an effort to improve antibiotic use in dentistry, best practices were developed to guide dentists through the entire antibiotic prescribing process, including pretreatment, prescribing, and patient and staff education. Pretreatment steps involve establishing a correct diagnosis, reviewing the patient’s pertinent medical history, and considering whether therapeutic management of a local bacterial infection with a procedure may be more appropriate than an antibiotic. Dentists should make their prescribing decisions based on evidence-based medicine. Additionally, dentists can educate patients to take antibiotics exactly as prescribed, only if prescribed for them, and not to save unused antibiotics for future use. Lastly, dentists and staff can stay current on optimal antibiotic prescribing practices through continuing education opportunities.
Dental organizations such as the American Dental Association (ADA), among others, have committed to improving antibiotic prescribing in order to maximize patient safety and reduce antibiotic overuse and misuse, which contribute to the development and spread of antibiotic resistance and the occurrence of adverse events, such as the sometimes deadly diarrhea caused by Clostridium difficile. These best practices will be a resource for dentists to apply when prescribing antibiotics to ensure patients are prescribed antibiotics only when the benefits outweigh the risks.
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