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Antimicrobial Stewardship in Dentistry

Dentists in BC account for about 18% of all community antibiotic prescriptions, making the profession important to the province’s antimicrobial stewardship efforts. Luckily, there are a few simple actions to help limit antibiotic prescribing in dentistry.

Below are tools and resources to help you ensure appropriate preventative antibiotic use, avoid clindamycin as a penicillin alternative and reduce unnecessary prescribing in your dental practice.

 

By avoiding unnecessary antibiotic prescribing, you:

  • Protect your patients' health: antibiotic courses affect the gut microbiome, which has an important role in immunity and human health
  • Increase patient safety: limiting the use of broad spectrum antibiotics decreases the risk of unnecessary side effects
  • Help ensure antibiotics continue to be effective in the future: 80% of dental prescriptions have been estimated to be unnecessary; avoiding these will help limit the development of resistant bacteria

Helpful tips to limit antibiotic prescribing

Drainage is the best treatment for abscesses

Drainage is the best treatment for localized abscesses because it provides immediate relief from pressure and pain and allows for the removal of pus, dead cells, and bacteria that are causing the infection. Antibiotics are only needed if there are signs of broader systemic issues, such as a fever.

A single dose for perioperative prophylaxis is enough

Longer courses for perioperative prophylaxis do not provide additional benefit and can often do more harm than good.

Prophylactic antibiotics are not suitable for everyone

Do not give prophylactic antibiotics before dental procedures for patients with total joint replacements, non-valvular cardiac prosthetic devices, or other body implants, because there is no evidence of benefit for these patients and considerable evidence of harm.

Many patients with a penicillin allergy label can safely take penicillin or other beta-lactam antibiotics

Many patients believe they are allergic to penicillin if they simply had side effects in the past, but a few questions can usually sort out if they are truly allergic, and if their concerns really do limit the use of beta lactams.


SOURCE: Antimicrobial Stewardship in Dentistry ( )
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