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148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions
BACKGROUND: Dentists prescribe 10% of outpatient antibiotics in the United States, equating to 24.5 million prescriptions annually. However, there is a paucity of data regarding adjunctive antibiotic use in tooth extractions. This study compared post-extraction infections following dental extraction...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777956/ http://dx.doi.org/10.1093/ofid/ofaa439.193 |
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author | Caniff, Kaylee E Young, Lisa R Truong, Shawna S Gretchen, Gibson Jurasic, Marianne M Poggensee, Linda Fitzpatrick, Margaret A Evans, Charlesnika T Suda, Katie J |
author_facet | Caniff, Kaylee E Young, Lisa R Truong, Shawna S Gretchen, Gibson Jurasic, Marianne M Poggensee, Linda Fitzpatrick, Margaret A Evans, Charlesnika T Suda, Katie J |
author_sort | Caniff, Kaylee E |
collection | PubMed |
description | BACKGROUND: Dentists prescribe 10% of outpatient antibiotics in the United States, equating to 24.5 million prescriptions annually. However, there is a paucity of data regarding adjunctive antibiotic use in tooth extractions. This study compared post-extraction infections following dental extractions with and without adjunctive antibiotics. Post-extraction infection risk factors and antibiotic prescribing patterns were also investigated. METHODS: This was a retrospective cohort of Veterans with tooth extraction(s) in any Veterans Affairs dental clinic from 1/1/17-12/31/17. A stratified random sample was selected by geographic region, type of extraction (surgical/non-surgical) and post-extraction antibiotic receipt to ensure inclusion of subjects in each of these categories. Subjects who received an antibiotic were compared to those who did not for the occurrence of post-extraction infection as documented in the health record by infectious signs/symptoms or diagnosis. Multivariable regression was performed to identify factors associated with antibiotic receipt. RESULTS: A sample size of 374 was needed to achieve statistical power based on a 10% risk of infection post-extraction. Nationally, 69,610 patients met inclusion criteria, of which 404 were randomly selected for inclusion. Antibiotics were prescribed to 154 patients (38.1%). There was no difference in post-extraction oral infection among subjects who did and did not receive antibiotics (4.5% vs. 3.2%, p=0.59). Risk factors for post-extraction infection could not be identified due to the low frequency of this outcome. Subjects who received antibiotic prescriptions were more likely to have a greater number of teeth extracted (OR=1.1; 95% CI 1.03–1.2), documentation of acute infection at time of extraction (OR=3.0; 95% CI 1.6–5.8), molar extraction (OR=1.8; 95% CI 1.1–2.9) and extraction performed by an oral maxillofacial surgeon (OR=2.3; 95% CI 1.5–3.6) or specialty dentist (OR=5.8; 95% CI 2.1–16.2). CONCLUSION: Infectious complications were not significantly different among Veterans undergoing tooth extraction who did and did not receive post-extraction antibiotics. Antibiotic prescribing for tooth extraction may be a potential area of focus for outpatient antimicrobial stewardship efforts. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-7777956 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77779562021-01-07 148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions Caniff, Kaylee E Young, Lisa R Truong, Shawna S Gretchen, Gibson Jurasic, Marianne M Poggensee, Linda Fitzpatrick, Margaret A Evans, Charlesnika T Suda, Katie J Open Forum Infect Dis Poster Abstracts BACKGROUND: Dentists prescribe 10% of outpatient antibiotics in the United States, equating to 24.5 million prescriptions annually. However, there is a paucity of data regarding adjunctive antibiotic use in tooth extractions. This study compared post-extraction infections following dental extractions with and without adjunctive antibiotics. Post-extraction infection risk factors and antibiotic prescribing patterns were also investigated. METHODS: This was a retrospective cohort of Veterans with tooth extraction(s) in any Veterans Affairs dental clinic from 1/1/17-12/31/17. A stratified random sample was selected by geographic region, type of extraction (surgical/non-surgical) and post-extraction antibiotic receipt to ensure inclusion of subjects in each of these categories. Subjects who received an antibiotic were compared to those who did not for the occurrence of post-extraction infection as documented in the health record by infectious signs/symptoms or diagnosis. Multivariable regression was performed to identify factors associated with antibiotic receipt. RESULTS: A sample size of 374 was needed to achieve statistical power based on a 10% risk of infection post-extraction. Nationally, 69,610 patients met inclusion criteria, of which 404 were randomly selected for inclusion. Antibiotics were prescribed to 154 patients (38.1%). There was no difference in post-extraction oral infection among subjects who did and did not receive antibiotics (4.5% vs. 3.2%, p=0.59). Risk factors for post-extraction infection could not be identified due to the low frequency of this outcome. Subjects who received antibiotic prescriptions were more likely to have a greater number of teeth extracted (OR=1.1; 95% CI 1.03–1.2), documentation of acute infection at time of extraction (OR=3.0; 95% CI 1.6–5.8), molar extraction (OR=1.8; 95% CI 1.1–2.9) and extraction performed by an oral maxillofacial surgeon (OR=2.3; 95% CI 1.5–3.6) or specialty dentist (OR=5.8; 95% CI 2.1–16.2). CONCLUSION: Infectious complications were not significantly different among Veterans undergoing tooth extraction who did and did not receive post-extraction antibiotics. Antibiotic prescribing for tooth extraction may be a potential area of focus for outpatient antimicrobial stewardship efforts. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777956/ http://dx.doi.org/10.1093/ofid/ofaa439.193 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Caniff, Kaylee E Young, Lisa R Truong, Shawna S Gretchen, Gibson Jurasic, Marianne M Poggensee, Linda Fitzpatrick, Margaret A Evans, Charlesnika T Suda, Katie J 148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions |
title | 148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions |
title_full | 148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions |
title_fullStr | 148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions |
title_full_unstemmed | 148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions |
title_short | 148. Post-Extraction Infection and Antibiotic Prescribing Among Veterans Receiving Dental Extractions |
title_sort | 148. post-extraction infection and antibiotic prescribing among veterans receiving dental extractions |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777956/ http://dx.doi.org/10.1093/ofid/ofaa439.193 |
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