{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:14:40Z","timestamp":1766391280485},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X21000167_as1\"><jats:title>Objective:<\/jats:title><jats:p>United States dentists prescribe 10% of all outpatient antibiotics. Assessing appropriateness of antibiotic prescribing has been challenging due to a lack of guidelines for oral infections. In 2019, the American Dental Association (ADA) published clinical practice guidelines (CPG) on the management of acute oral infections. Our objective was to describe baseline national antibiotic prescribing for acute oral infections prior to the release of the ADA CPG and to identify patient-level variables associated with an antibiotic prescription.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000167_as2\"><jats:title>Design:<\/jats:title><jats:p>Cross-sectional analysis.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000167_as3\"><jats:title>Methods:<\/jats:title><jats:p>We performed an analysis of national VA data from January 1, 2017, to December 31, 2017. We identified cases of acute oral infections using<jats:italic>International Classification of Disease, Tenth Revision, Clinical Modification<\/jats:italic>(ICD-10-CM) codes. Antibiotics prescribed by a dentist within \u00b17 days of a visit were included. Multivariable logistic regression identified patient-level variables associated with an antibiotic prescription.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000167_as4\"><jats:title>Results:<\/jats:title><jats:p>Of the 470,039 VA dental visits with oral infections coded, 12% of patient visits with irreversible pulpitis, 17% with apical periodontitis, and 28% with acute apical abscess received antibiotics. Although the median days\u2019 supply was 7, prolonged use of antibiotics was frequent (\u22658 days, 42%\u201349%). Patients with high-risk cardiac conditions, prosthetic joints, and endodontic, implant, and oral and maxillofacial surgery dental procedures were more likely to receive antibiotics.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000167_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Most treatments of irreversible pulpitis and apical periodontitis cases were concordant with new ADA guidelines. However, in cases where antibiotics were prescribed, prolonged antibiotic courses &gt;7 days were frequent. These findings demonstrate opportunities for the new ADA guidelines to standardize and improve dental prescribing practices.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2021.16","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T10:38:42Z","timestamp":1614681522000},"page":"1422-1430","update-policy":"http:\/\/dx.doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Concordance of antibiotic prescribing with the American Dental Association acute oral infection guidelines within Veterans\u2019 Affairs (VA) dentistry"],"prefix":"10.1017","volume":"42","author":[{"given":"Daniel B.","family":"Carlsen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Durkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gretchen","family":"Gibson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Marianne","family":"Jurasic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Poggensee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret A.","family":"Fitzpatrick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Echevarria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessina","family":"McGregor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlesnika T.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie J.","family":"Suda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"S0899823X21000167_ref3","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.japh.2016.08.015","article-title":"Antibiotic prescriptions in the community by type of provider in the United States, 2005\u20132010","volume":"56","author":"Suda","year":"2016","journal-title":"J Am Pharm Assoc (2003)"},{"key":"S0899823X21000167_ref5","unstructured":"5. Antibiotic resistance threats in the United States, 2013. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/drugresistance\/threat-report-2013\/pdf\/ar-threats-2013-508.pdf. Published 2013. 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Antibiotic use for the emergency management of dental pain and swelling clinical practice guideline, 2019. American Dental Association website. https:\/\/ebd.ada.org\/en\/evidence\/guidelines\/antibiotics-for-dental-pain-and-swelling. Published 2019. 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Antibiotic resistance: Global report on surveillance, 2014. World Health Organization website. http:\/\/www.who.int\/drugresistance\/documents\/surveillancereport\/en\/. Published 2014. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}