Concordance of antibiotic prescribing with the American Dental Association acute oral infection guidelines within Veterans' Affairs (VA) dentistry.
Concordance of antibiotic prescribing with the American Dental Association acute oral infection guidelines within Veterans' Affairs (VA) dentistry.
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DOI：
10.1017/ice.2021.16
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发表时间：
2021-12
影响因子：
4.5
通讯作者：
Suda KJ
中科院分区：
文献类型：
--
作者：
Carlsen DB;Durkin MJ;Gibson G;Jurasic MM;Patel U;Poggensee L;Fitzpatrick MA;Echevarria K;McGregor J;Evans CT;Suda KJ
美国牙医开出了 10% 的门诊抗生素。由于缺乏口腔感染指南，评估抗生素处方的适当性一直具有挑战性。 2019年，美国牙科协会（ADA）发布了关于急性口腔感染管理的临床实践指南（CPG）。我们的目标是在 ADA CPG 发布之前描述国家急性口腔感染抗生素处方的基线，并确定与抗生素处方相关的患者水平变量。横截面分析。我们对 2017 年 1 月 1 日至 2017 年 12 月 31 日期间的国家 VA 数据进行了分析。我们使用 ICD-10-CM 代码识别了急性口腔感染病例。牙医在就诊后 7 天内开出的抗生素也包括在内。多变量逻辑回归确定了与抗生素处方相关的患者水平变量。在 470,039 例因口腔感染而就诊的 VA 牙科诊所中，12% 的患者接受了抗生素治疗，其中 12% 的患者患有不可逆牙髓炎，17% 的患者患有根尖周炎，28% 的患者患有急性根尖脓肿。尽管中位数供应天数为 7 天，但长期使用抗生素的情况很常见（42-49% ≥8 天）。患有高风险心脏病、假体关节、牙髓、种植和口腔颌面外科牙科手术的患者更有可能接受抗生素治疗。大多数不可逆牙髓炎和根尖周炎病例均符合新的 ADA 指南。然而，在开出抗生素的情况下，抗生素疗程超过 7 天的情况很常见。这些发现表明新的 ADA 指南有机会标准化和改进牙科处方实践。
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. Cross-sectional analysis. We performed an analysis of national VA data from 1/1/2017 – 12/31/2017. We identified cases of acute oral infections using ICD-10-CM codes. Antibiotics prescribed by a dentist within ± 7 days of a visit were included. Multivariable logistic regression identified patient-level variables associated with an antibiotic prescription. 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’ supply was 7, prolonged use of antibiotics was frequent (42–49% ≥8 days). Patients with high risk cardiac conditions, prosthetic joints, and endodontic, implant, and oral and maxillofacial surgery dental procedures were more likely to receive antibiotics. The majority of irreversible pulpitis and apical periodontitis cases were found to be concordant with new ADA guidelines. However, in cases where antibiotics were prescribed, prolonged antibiotic courses greater than 7 days were frequent. These findings demonstrate opportunities for the new ADA guidelines to standardize and improve dental prescribing practices.
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影响因子：
3.9
作者：
Durkin, Michael J.;Hsueh, Kevin;Fraser, Victoria J.
通讯作者：
Fraser, Victoria J.
影响因子：
120.7
作者：
Fleming-Dutra, Katherine E.;Hersh, Adam L.;Hicks, Lauri A.
通讯作者：
Hicks, Lauri A.
影响因子：
5.2
作者：
Deshpande, Abhishek;Pasupuleti, Vinay;Donskey, Curtis J.
通讯作者：
Donskey, Curtis J.
影响因子：
4.5
作者：
Gross, Alan E.;Suda, Katie J.;McGregor, Jessina C.
通讯作者：
McGregor, Jessina C.
DOI：
10.1016/j.japh.2016.08.015
发表时间：
2016-11-01
影响因子：
2.1
作者：
Suda, Katie J.;Roberts, Rebecca M.;Taylor, Thomas H.
通讯作者：
Taylor, Thomas H.