Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-05T08:08:25.743Z Has data issue: false hasContentIssue false
  • English
  • Français

Postextraction infection and antibiotic prescribing among veterans receiving dental extractions

Published online by Cambridge University Press:  02 March 2021

Kaylee E. Caniff ,
Lisa R. Young ,
Shawna Truong ,
Gretchen Gibson ,
M. Marianne Jurasic ,
Linda Poggensee ,
Margaret A. Fitzpatrick ,
Charlesnika T. Evans  and
Katie J. Suda
Kaylee E. Caniff
Affiliation:
Jesse Brown VA Medical Center, Chicago, Illinois
Lisa R. Young
Affiliation:
Jesse Brown VA Medical Center, Chicago, Illinois
Shawna Truong
Affiliation:
Jesse Brown VA Medical Center, Chicago, Illinois
Gretchen Gibson
Affiliation:
VHA Office of Dentistry, Department of Veterans’ Affairs, Washington, DC
M. Marianne Jurasic
Affiliation:
VHA Office of Dentistry, Department of Veterans’ Affairs, Washington, DC Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans’ Hospital, Boston, Massachusetts Boston University, School of Dental Medicine, Boston, Massachusetts
Linda Poggensee
Affiliation:
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois
Margaret A. Fitzpatrick
Affiliation:
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
Charlesnika T. Evans
Affiliation:
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Katie J. Suda*
Affiliation:
Center of Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
*
Author for correspondence: Katie Suda, E-mail: [email protected]; [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To characterize postextraction antibiotic prescribing patterns, predictors for antibiotic prescribing and the incidence of and risk factors for postextraction oral infection.

Design:

Retrospective analysis of a random sample of veterans who received tooth extractions from January 1, 2017 through December 31, 2017.

Setting:

VA dental clinics.

Patients:

Overall, 69,610 patients met inclusion criteria, of whom 404 were randomly selected for inclusion. Adjunctive antibiotics were prescribed to 154 patients (38.1%).

Intervention:

Patients who received or did not receive an antibiotic were compared for the occurrence of postextraction infection as documented in the electronic health record. Multivariable logistic regression was performed to identify factors associated with antibiotic receipt.

Results:

There was no difference in the frequency of postextraction oral infection identified among patients who did and did not receive antibiotics (4.5% vs 3.2%; P = .59). Risk factors for postextraction infection could not be identified due to the low frequency of this outcome. Patients who received antibiotics were more likely to have a greater number of teeth extracted (aOR, 1.10; 95% CI, 1.03–1.18), documentation of acute infection at time of extraction (aOR, 3.02; 95% CI, 1.57–5.82), molar extraction (aOR, 1.78; 95% CI, 1.10–2.86) and extraction performed by an oral maxillofacial surgeon (aOR, 2.29; 95% CI, 1.44–3.58) or specialty dentist (aOR, 5.77; 95% CI, 2.05–16.19).

Conclusion:

Infectious complications occurred at a low incidence among veterans undergoing tooth extraction who did and did not receive postextraction antibiotics. These results suggest that antibiotics have a limited role in preventing postprocedural infection; however, future studies are necessary to more clearly define the role of antibiotics for this indication.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 12 , December 2021 , pp. 1431 - 1436
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Roberts, RM, Bartoces, M, Thompson, SE, Hicks, LA. Antibiotic prescribing by general dentists in the United States, 2013. J Am Dent Assoc 2017;148:172–178.e1.Google ScholarPubMed
Lockhart, PB, Tampi, MP, Abt, E, et al. Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling. J Am Dent Asso 2019;150:906–921.e12.CrossRefGoogle ScholarPubMed
Lodi, G, Figini, L, Sardella, A, et al. Antibiotics to prevent complications following tooth extractions. Cochrane Database Syst Revs 2012;11:CD003811.Google ScholarPubMed
Chow, AW. Infections of the oral cavity, neck, and head. In: Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 9th edition. Philadelphia, PA: Elsevier; 2020.Google Scholar
Robertson, DP, Keys, W, Rautemaa-Richardson, R, et al. Management of severe acute dental infections. BMJ 2015;350:h1300.CrossRefGoogle ScholarPubMed
Society for Healthcare Epidemiology of America; Infectious Diseases Society of America; Pediatric Infectious Diseases Society. Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol 2012;33:322–327.CrossRefGoogle Scholar
Price, LE, Shea, K, Gephart, S. The Veterans’ Affairs Corporate Data Warehouse: uses and implications for nursing research and practice. Nurs Adm Q 2015;39:311–318.Google Scholar
Suda, KJ, Henschel, H, Patel, U, et al. Use of antibiotic prophylaxis for tooth extractions, dental implants, and periodontal surgical procedures. Open Forum Infect Dis 2018;5(1):ofx250.Google ScholarPubMed
Braimah, RO, Ndukwe, KC, Owotade, JF, Aregbesola, SB. Impact of oral antibiotics on health-related quality of life after mandibular third molar surgery: an observational study. Niger J Clin Pract 2017;20:1189–1194.CrossRefGoogle ScholarPubMed
Limeres Posse, J, Álvarez Fernández, M, Fernández Feijoo, J, et al. Intravenous amoxicillin/clavulanate for the prevention of bacteraemia following dental procedures: a randomized clinical trial. J Antimicrob Chemother 2016;71:2022–2030.CrossRefGoogle ScholarPubMed
Arteagoitia, I, Ramos, E, Santamaria, G, et al. Amoxicillin/clavulanic acid 2000/125 mg to prevent complications due to infection following completely bone-impacted lower third molar removal: a clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:8–16.CrossRefGoogle ScholarPubMed
Iglesias-Martín, F, García-Perla-García, A, Yañez-Vico, R, et al. Comparative trial between the use of amoxicillin and amoxicillin clavulanate in the removal of third molars. Med Oral Patol Oral Cir Bucal 2014;19(6):e612–5.Google ScholarPubMed
Barasch, A, Safford, MM, Litaker, MS, Gilbert, GH. Risk factors for oral postoperative infection in patients with diabetes. Spec Care Dentist 2008;28:159–166.CrossRefGoogle ScholarPubMed
Ray, MJ, Tallman, GB, Bearden, DT, et al. Antibiotic prescribing without documented indication in ambulatory are clinics: national cross sectional study. BMJ 2019;367:16461.Google ScholarPubMed
Sanchez, GV, Fleming-Dutra, KE, Roberts, RM, Hicks, LA. Core elements of outpatient antibiotic stewardship. MMWR 2016;65:1–12.Google ScholarPubMed
Meeker, D, Linder, JA, Fox, CR, et al. Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial. JAMA 2016;315:562–570.CrossRefGoogle ScholarPubMed
Chate, RA, White, S, Hale, LR, et al. The impact of clinical audit on antibiotic prescribing in general dental practice. Br Dent J 2006;201:635–641.CrossRefGoogle ScholarPubMed
Seager, JM, Howell-jones, RS, Dunstan, FD, et al. A randomised controlled trial of clinical outreach education to rationalise antibiotic prescribing for acute dental pain in the primary care setting. Br Dent J 2006;201:217–222.CrossRefGoogle ScholarPubMed
Gross, AE, Hanna, D, Rowan, SA, Bleasdale, SC, Suda, KJ. Successful implementation of an antibiotic stewardship program in an academic dental practice. Open Forum Infect Dis 2019;6(3):ofz067.CrossRefGoogle Scholar