Document Type
Article
Publication Title
Journal of Public Health Dentistry
Abstract
Objectives
We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System.
Methods
We conducted a retrospective cohort study of patients undergoing dental extractions in 2015–2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome.
Results
Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (p = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13–1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92–1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83–1.30).
Conclusions
In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use.
DOI
10.1111/jphd.12634
Publication Date
8-12-2024
Keywords
antibiotic, antibiotic prophylaxis, dentist, medication safety, prescribing patterns, tooth extraction
ISSN
1752-7325
Recommended Citation
McGregor JC, Wilson GM, Gibson G, Jurasic M, Evans CT, Suda KJ. The Effect of Antibiotic Premedication on Postoperative Complications Following Dental Extractions. Journal of Public Health Dentistry. 2024; . doi: 10.1111/jphd.12634.
