Beliefs Concerning Antibiotic Prophylaxis Among National Dental-PBRN Dentists

Objectives: The study objective was to explore dentists’ beliefs and opinions related to antibiotic prophylaxis (AP) guidelines and prescribing practices aimed at preventing distant site infection following invasive dental procedures, with a focus on infective endocarditis (IE) and prosthetic joint infection (PJI).
Methods: A multidisciplinary study team developed and disseminated via REDCap email a 10-question survey, including sub-questions, to 3,584 general dentist and specialist members of the National Dental Practice-Based Research Network (www.NationalDentalPBRN.org).
Results: We had 2,169 eligible dentists (61%) respond to this survey - 79% general practitioners and 21% specialists. They represented the anticipated age range (25-86) for practicing dentists across the 6 Network regions in the U.S. Dentists were from inner city or urban (41%), suburban (45%) or rural (14%) locations. Respondents see these patients at risk for IE (35%) and PJI (65%) at least once per week. Although 77% of dentists agree that the American Heart Association guidelines for IE are well-defined and clear, only 49% feel this way concerning PJI guidelines. Similarly, 75% of dentists agree that the IE-risk patient groups are well-defined and clear vs. 47% for PJI-risk patients. 72% of respondents acknowledged that the dental procedures of concern were well-defined and clear for patients at risk for IE vs. 56% for PJI. Differences in clarity also exist for questions regarding appropriate antibiotic regimens (IE - 88% vs. PJI - 74%), and the need to consult with the patient’s cardiologist or orthopedist (49% vs. 59%, respectively). Additionally, dentist’s opinions on AP were influenced by a variety of factors including a concern for negative outcomes from AP use in general.

Conclusions: Our results demonstrate the need for further studies on the risks and benefits from antibiotic prophylaxis in patients at risk for IE or PJI to resolve ambiguities within existing professional guidelines.