Dental antibiotics could be adding to <I>C. difficile </I> cases

In 2013, dentists reportedly wrote 24 million prescriptions for antibiotics&#8212;a known risk factor for <I>Clostridium difficile</I>, which can be fatal. Now, new research out of Michigan appears to confirm a connection between dental antibiotic prescribing and <I>C. difficile</I> cases, which approached 500,000 in 2011.

In 2013, dentists reportedly wrote 24 million prescriptions for antibiotics—a known risk factor for Clostridium difficile, which can be fatal. Now, new research out of Michigan appears to confirm a connection between dental antibiotic prescribing and C. difficile cases, which approached 500,000 in 2011. According to CDC epidemiology field officer and lead investigator Stacy Holzbauer, DVM, MPH, dentists may not be on top of the latest antibiotic prescribing guidelines, may not be sticklers about warning patients on the potential risks, and likely are not being approached by patients who suffer diarrhea or other adverse effects after taking the medication. At the same time, she adds, there is a disconnect between dentists, physicians, and patients that keeps all parties from being fully informed about the patient's history of antibiotic use. For the study, Holzbauer and colleagues at the Minnesota Department of Health interviewed 1,626 individuals from five counties in the state who were diagnosed with community-acquired C. difficile from 2009–15. Of the 926 who had been prescribed an antibiotic in the prior 12 weeks, 136—or 15%—had received their order from a dental provider. Yet, for more than one-third of those 136 patients, there was no documentation of the prescription in their medical chart. Holzbauer hopes that future research will identify the prescribers of patients who develop C. difficile and target them for intervention. "We've seen in outpatient clinics that peer feedback and peer comparisons seem to be most effective in reducing inappropriate prescribing," she noted.