{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:18:57Z","timestamp":1792513137326,"version":"4.5.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T00:00:00Z","timestamp":1563321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>Dentists prescribe a large portion of all oral antibiotics, and these are associated with a risk of adverse drug reactions (ADRs). The aim of this study was to quantify the risk of ADRs associated with oral antibiotics commonly prescribed by dentists. NHS Digital Prescribing data and Yellow Card Drug Analysis data for 2010 to 2017 were abstracted to quantify dental antibiotic prescribing in England, and the rate and types of ADRs associated with them. During the period of study, the mean number of actively practicing dentists in England was 23,624. Amoxicillin accounted for 64.8% of dental antibiotic prescribing and had the lowest reported rate of fatal ADRs (0.1\/million prescriptions) and overall ADRs (21.5\/million prescriptions). Indeed, amoxicillin was respectively 6 and 3 times less likely to cause an ADR than the other penicillins, penicillin V and amoxicillin + clavulanic acid, and appears to be very safe in patients with no history of penicillin allergy. In contrast, clindamycin, which is often used in patients with penicillin allergy, had the highest rate of fatal (2.9\/million prescriptions) and overall (337.3\/million prescriptions) ADRs, with Clostridiodes (formerly Clostridium) difficile infections pivotal to its ADR profile. Other amoxicillin alternatives, clarithromycin and metronidazole, while significantly worse than amoxicillin, were 3 and nearly 5 times less likely to cause an ADR than clindamycin. Ranked from least to most likely to cause an ADR, antibiotics most commonly prescribed were as follows: amoxicillin &lt; cephalosporins &lt; erythromycin &lt; tetracyclines &lt; azithromycin &lt; metronidazole &lt; amoxicillin + clavulanic acid &lt; clarithromycin &lt; penicillin V &lt; clindamycin. This study confirmed the high level of safety associated with use of amoxicillin by dentists and the significantly worse rates of fatal and nonfatal ADRs associated with other penicillins and alternatives to amoxicillin for those who are penicillin allergic. In particular, clindamycin had the highest rate of fatal and nonfatal ADRs of any of the antibiotics commonly prescribed by dentists.<\/jats:p>","DOI":"10.1177\/0022034519863645","type":"journal-article","created":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T17:06:11Z","timestamp":1563383171000},"page":"1081-1087","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":86,"title":["Risk of Adverse Reactions to Oral Antibiotics Prescribed by Dentists"],"prefix":"10.1177","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0681-4083","authenticated-orcid":false,"given":"M.H.","family":"Thornhill","sequence":"first","affiliation":[{"name":"Unit of Oral and Maxillofacial Medicine Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK"},{"name":"Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.J.","family":"Dayer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Taunton and Somerset NHS Trust, Taunton, Somerset, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4652-7089","authenticated-orcid":false,"given":"M.J.","family":"Durkin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.B.","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.M.","family":"Baddour","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine and the Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"bibr1-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm090"},{"key":"bibr2-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2018.11.001"},{"key":"bibr3-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02176-12"},{"key":"bibr4-0022034519863645","unstructured":"Centers for Disease Control and Prevention. 2019. Is it really a penicillin allergy? [accessed 2019 Mar 5]. https:\/\/www.cdc.gov\/antibiotic-use\/community\/pdfs\/penicillin-factsheet.pdf."},{"key":"bibr5-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1159\/000112313"},{"key":"bibr6-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3402"},{"key":"bibr7-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2017.07.019"},{"key":"bibr8-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1080\/00016357.2017.1347822"},{"key":"bibr9-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1111\/adj.12427"},{"key":"bibr10-0022034519863645","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.82a.14111"},{"key":"bibr11-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1177\/2049936113501816"},{"key":"bibr12-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2017.07.001"},{"issue":"9","key":"bibr13-0022034519863645","first-page":"1308","volume":"60","author":"Hicks LA","year":"2015","journal-title":"Clin Infect Dis"},{"key":"bibr14-0022034519863645","unstructured":"International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use. 2019. Medical dictionary for regulatory activities; [accessed 2019 Feb 24]. https:\/\/www.meddra.org."},{"key":"bibr15-0022034519863645","doi-asserted-by":"publisher","DOI":"10.4103\/0970-4388.180444"},{"key":"bibr16-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-014-0476-y"},{"key":"bibr17-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.09.021"},{"key":"bibr18-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2013.02.002"},{"key":"bibr19-0022034519863645","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/08-073"},{"key":"bibr20-0022034519863645","unstructured":"National Institute for Health and Care Excellence. 2008. Clinical guideline [cg64]. Prophylaxis against infective endocarditis. http:\/\/www.nice.org.uk\/guidance\/cg64."},{"key":"bibr21-0022034519863645","unstructured":"National Institute for Health and Care Excellence. 2014. Clinical guideline [cg183]. Drug allergy: diagnosis and management; [accessed 2019 Mar 5]. https:\/\/www.nice.org.uk\/guidance\/CG183."},{"key":"bibr22-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/46.6.1033"},{"key":"bibr23-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.19283"},{"issue":"1","key":"bibr24-0022034519863645","first-page":"75","volume":"13","author":"Tanwir F","year":"2015","journal-title":"Oral Health Prev Dent"},{"key":"bibr25-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1111\/adj.12622"},{"key":"bibr26-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv115"},{"key":"bibr27-0022034519863645","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.6510"}],"container-title":["Journal of Dental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0022034519863645","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0022034519863645","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0022034519863645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:08:12Z","timestamp":1777496892000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0022034519863645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,17]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1177\/0022034519863645"],"URL":"https:\/\/doi.org\/10.1177\/0022034519863645","relation":{},"ISSN":["0022-0345","1544-0591"],"issn-type":[{"value":"0022-0345","type":"print"},{"value":"1544-0591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,17]]}}}