Antibiotics: The Good, The Bad, And The Ugly

Antimicrobials, antibiotics among them, are unique among medications in the way they intersect personal and public health. Successful treatment of patients for bacterial infections will result in decreased spread of infections in the community. Not long after the discovery of these miracle drugs, however, patients’ use of antibiotics also created resistant bacteria, which is a serious public health concern. It is estimated that more than 70% of illness-causing bacteria are resistant to at least 1 antibiotic. Numbers may lie, but with an estimated 50,000 deaths due to antibiotic resistance in 2015 in the United States and Europe alone—and a projected death toll of 10 million worldwide every year by 2050—the continued benefits from antibiotics may be dwindling rapidly. In the United States alone, every year 23,000 deaths and more than 2 million infections are attributed to antibiotic-resistant bacteria. The primary reason for the increase in antibiotic resistance is its excessive use.

     

Most Dental Patients Do Not Require Antibiotic Prophylaxis Prior To Procedures

The Washington Post discussed antibiotic prophylaxis, stating that revised guidelines recommend fewer people receive antibiotics before a dental procedure. The article notes that a 2014 American Dental Association panel “reviewed studies comparing the dental histories of people who had contracted infections of artificial joints with those of similar people with replaced joints who remained infection-free,” finding “no statistical connection between dental visits and subsequent joint infections, regardless of whether patients had taken antibiotics.” In 2015, the ADA published new clinical practice guidelines concerning prophylactic antibiotics for patients with prosthetic joints.

        The ADA News reported previously that a continuing education course at ADA 2016 – America’s Dental Meeting will focus on prophylactic antibiotic use. According to the article, “The session, Prophylactic Antibiotic Use and a ‘Different’ Kind of Joint (5352), will be led by Dr. Tom Sollecito, the lead author of a 2015 report from the ADA Council on Scientific Affairs that offers guidelines about the use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints.”

        The guidelines, “The Use of Prophylactic Antibiotics Prior to Dental Procedures in Patients with Prosthetic Joints,” are available for download at JADA.ADA.org. MouthHealthy.org and the Oral Health Topics on ADA.org also provide information on prophylactic antibiotic use for patients and for dental professionals.