Could Antibiotics from Dentists Cause Superbug Infections

Researchers have found that antibiotics prescribed as a preventive measure by dentists could increase the growth of the bacterium, Clostridium Difficile (C. diff), which can infect the bowel and cause severe diarrhea.

The Research

The Minnesota Department of Health tracked C. diff infections in the community (i.e. patients who did not have an overnight stay in a hospital or nursing home) in their state for 6 years. During this time, they found:

15% of those with the infection who had taken antibiotics had them prescribed for dental procedures.

Of this 15% of patients, researchers determined: 34% of those patients’ had no history of receiving dental procedure-related antibiotics.

It was reported that dentists were challenged to prescribe the appropriate antibiotic, including confusion about among prescribing guidelines. In an earlier survey also carried out by the Minnesota Department of Health, found:

36% of dentists prescribed antibiotics in circumstances, which would generally not be recommended by the American Dental Association (ADA).

Lead author Dr Stacy Holzbauer said,

“Dentists have been overlooked as a source of antibiotic prescribing, which can potentially delay treatment when doctors are trying to determine what is causing a patient’s illness,”

“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.”

Dentists prescribe antibiotics in certain situations to treat oral infections. However, some dentists prescribe antibiotics as a preventive measure to reduce the risk of a heart infection in patients with heart conditions or to prevent infection on an artificial joint, such as hip or knee replacement. Such prescription of antibiotics is no longer recommended by the American Dental Association. It is also noted that the risk of developing infections such as C diff. from using antibiotics is greater than developing in the cases described.

“It is possible some dentists aren’t aware of the updated recommendations or are being asked by other healthcare providers to continue preventive antibiotics despite the change,” said  Dr Holzbauer.

The improper use of antibiotics helps fuel the increase in drug-resistant bacteria, which can make treating them more difficult and increase the risk for the public.

 

Key Statistics

  • The Minnesota Department of Health researchers interviewed 1,626 people with community-associated C. diff between 2009 and 2015.
  • 57% reported they had been prescribed antibiotics.
  • 15% of those who had been prescribed antibiotics, were for dental procedures.
  • Of this 15% of patients, researchers determined: 34% of those patients’ had no history of receiving dental procedure-related antibiotics.
  • The study found patients who were prescribed antibiotics for dental procedures tended to be older.
  • Patients were more likely to receive clindamycin, an antibiotic that is associated with C. diff infection.

Survey of dentists carried out by the Minnesota Department of Health found less than 50% of dentists were concerned about the serious effects of antibiotic resistance or C diff. to affect their decision to affect their prescribing decisions.

Dr Holzbauer believes that this decision is due to the dentists being unaware when their patients develop C diff. and explains that better communication between dental and medical communities, with improved history taking by all prescribers, would help.

“Research has shown that reducing outpatient antibiotic prescribing by 10 percent could decrease C. diff rates outside of hospitals by 17 percent,” said Dr. Holzbauer.

“Limiting the use of inappropriate antibiotics in dentistry could also have a profound impact.”