256. A Cross-Disciplinary Educational Approach: Antibiotic Prescribing Practices and the Use of Prophylactic Antibiotics Prior to Dental Procedures

BACKGROUND: Antibiotics are frequently prescribed for prophylaxis prior to dental procedures. Little is known about the influences and beliefs among medical and dental practitioners regarding prophylactic antibiotic prescription prior to dental procedures among patients with prosthetic joints and those at risk for endocarditis. METHODS: A cross-sectional electronic survey was designed and distributed among medical practitioners (physicians, APRNs and PAs in Primary Care, Cardiology, and Orthopedics), and dentists. The survey addressed the frequency of prophylactic antibiotic prescribing, factors influencing prophylactic antibiotic use, perceived responsibility for antibiotic prescribing and interest in further antibiotic-related education. RESULTS: Among 336 survey recipients, 156 responded (response rate 46%), including 84 dentists and 72 medical practitioners. A higher proportion of dentists reported ≥1 prophylactic antibiotic prescriptions in the prior year compared with medical providers (79% vs. 58%). Most dentists (68%) believed that the dentist was responsible for prescribing the prophylactic antibiotic, whereas medical practitioners attributed this responsibility to the dentist (35%), the medical or surgical specialist (26%), or the primary care physician (38%). Dentists were more likely than medical practitioners to identify the following as indications for prophylactic antibiotics: poorly controlled diabetes mellitus (26% vs. 3%, P = 0.000), chronic kidney disease (8% vs. 0%, P = 0.041), cardiac transplant with valvopathy (61% vs. 40%, P = 0.023), and previous endocarditis (85% vs. 65% P = 0.005). Most medical providers (65%) and dentists (74%) reported interest in more education on prescribing antibiotics, with educational modules either online modules or email communications (58% and 54% of interested providers, respectively). CONCLUSION: Medical providers and dentists frequently prescribe antibiotics prior to dental procedures. Beliefs regarding the responsibility and indications for prescribing varied by group and may not be consistent with published guidelines. Additional education, particularly through online or email, would be an opportunity to address the needs of these prescribers. DISCLOSURES: All authors: No reported disclosures.