Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners

Antibiotic prophylaxis guidelines have been developed for health care and dentistry. The authors examined whether dentists were following the 2007 American Heart Association (AHA) and the 2012 American Association of Orthopaedic Surgeons (AAOS) recommendations for antibiotic prophylaxis.

A survey was sent to 600 dentists in the south-central region of the United States. The survey examined dentists' prescribing practices for patients with cardiac and prosthetic joint replacements, antibiotic regimen prescribed, confidence in their prescription decisions, and dentistry's contribution to antibiotic resistance.

The response rate was 28.7% (n = 172). Dentists followed the 2007 AHA guidelines for patients with a history of infective endocarditis (95%), and cardiac valves repaired with prosthetic materials (76%) or animal/donor tissue (61%). For prosthetic joint replacement, 72% prescribed antibiotic prophylaxis within the first 2 years after placement and 58% continued to prescribe after 2 years. Amoxicillin was the most frequently prescribed antibiotic for cardiac conditions (92%) and prosthetic joint replacements (77%). No significant differences were found in relation to dentists' gender (p = 0.75), year of graduation (p = 0.71), scope of practice (p = 0.30), and their confidence in their prescription decisions; 73% believed taking multiple doses of antibiotics leads to antibiotic resistance.

The majority of dentists were following the 2007 AHA guidelines. Confusion regarding the 2012 AAOS guidelines for prosthetic joint replacement was evident.

Keeping current with changing antibiotic prophylaxis guidelines ensures dentists are providing the best evidence-based dentistry for their patients.