Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 23;23(1):427.
doi: 10.1186/s12879-023-08400-y.

Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints

Swetha Ramanathan  1 , Charlesnika T Evans  2   3 , Ronald C Hershow  1 , Gregory S Calip  4 , Susan Rowan  5 , Colin Hubbard  6 , Katie J Suda  7   8
Affiliations

Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints

Swetha Ramanathan et al. BMC Infect Dis. .

Abstract

Background: No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings.

Methods: This was a retrospective study of veteran and non-veteran dental patients with cardiac conditions or prosthetic joints between 2015-2017. Multivariable log binomial regression analysis was conducted to compare concordant prescribing by setting with a sub-analysis for errors of dosing based on antibiotic duration (i.e., days prescribed).

Results: A total of 61,124 dental visits that received a prophylactic antibiotic were included. Most were male (61.0%), and 55 years of age or older (76.2%). Nearly a third (32.7%) received guideline concordant prophylaxis. VA dental settings had a lower prevalence of guideline concordant prescribing compared to non-VA settings in unadjusted results (unadjusted prevalence ratio [uPR] = 0.92, 95% CI: 0.90-0.95). After adjustment, prevalence of guideline concordant prescribing was higher in those with prosthetic joints in the VA setting (adjusted prevalence ratio [aPR] = 1.73, 95% CI: 1.59-1.88), with no difference identified in those without a prosthetic joint (aPR = 0.99, 95% CI: 0.96-1.01). Concordance of dosing was higher in VA compared to non-VA settings (aPR = 1.11, 95% CI: 1.07-1.15).

Conclusions: VA has a higher prevalence of guideline concordant prescribing among those with prosthetic joints and when assessing dosing errors. Though the presence of an integrated electronic health record (EHR) may be contributing to these differences, other system or prescriber-related factors may be responsible. Future studies should focus on to what extent the integrated EHR may be responsible for increased guideline concordant prescribing in the VA setting.

Keywords: Antibiotics; Dentists; Guideline Concordant Prescribing; Private Practice; Prophylaxis; VA Dentistry.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
VA Cohort Identification Flowchart
Fig. 2
Fig. 2
Non- VA Cohort Identification Flowchart
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Suda KJ, Hicks LA, Roberts RM, Hunkler RJ, Taylor TH., Jr Trends and seasonal variation in outpatient antibiotic prescription rates in the United State, 2006 to 2010. Antimicrob Agents Chemother. 2014;58(5):2763–2766. doi: 10.1128/AAC.02239-13. - DOI - PMC - PubMed
    1. Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA. 2016;315(17):1864–1873. doi: 10.1001/jama.2016.4151. - DOI - PubMed
    1. Hicks LA, Bartoces MG, Roberts RM, et al. US outpatient antibiotic prescribing variation according to geography, patient population, and provider specialty in 2011. Clin Infect Dis. 2015;60(9):1308–1316. - PubMed
    1. Sturrock A, Landes D, Robson T, Bird L, Ojelabi A, Ling J. An audit of antimicrobial prescribing by dental practitioners in the north east of England and Cumbria. BMC Oral Health. 2018;18(206):1–8. - PMC - PubMed
    1. Rethman MP, Watters W, III, Buck H, et al. The American Academy of Orthopaedic Surgeons and the American Dental Association clinical practice guideline on the prevention of orthopaedic implant infection in patients undergoing dental procedures. J Bone Joint Surg Am. 2013;95(8):745–747. doi: 10.2106/00004623-201304170-00011. - DOI - PubMed

Substances