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Postextraction infection and antibiotic prescribing among veterans receiving dental extractions

Published online by Cambridge University Press:  02 March 2021

Kaylee E. Caniff ,
Lisa R. Young ,
Shawna Truong ,
Gretchen Gibson ,
M. Marianne Jurasic ,
Linda Poggensee ,
Margaret A. Fitzpatrick ,
Charlesnika T. Evans  and
Katie J. Suda
Kaylee E. Caniff
Affiliation:
Jesse Brown VA Medical Center, Chicago, Illinois
Lisa R. Young
Affiliation:
Jesse Brown VA Medical Center, Chicago, Illinois
Shawna Truong
Affiliation:
Jesse Brown VA Medical Center, Chicago, Illinois
Gretchen Gibson
Affiliation:
VHA Office of Dentistry, Department of Veterans’ Affairs, Washington, DC
M. Marianne Jurasic
Affiliation:
VHA Office of Dentistry, Department of Veterans’ Affairs, Washington, DC Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans’ Hospital, Boston, Massachusetts Boston University, School of Dental Medicine, Boston, Massachusetts
Linda Poggensee
Affiliation:
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois
Margaret A. Fitzpatrick
Affiliation:
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
Charlesnika T. Evans
Affiliation:
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Katie J. Suda*
Affiliation:
Center of Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
*
Author for correspondence: Katie Suda, E-mail: [email protected]; [email protected]
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Abstract

Objective:

To characterize postextraction antibiotic prescribing patterns, predictors for antibiotic prescribing and the incidence of and risk factors for postextraction oral infection.

Design:

Retrospective analysis of a random sample of veterans who received tooth extractions from January 1, 2017 through December 31, 2017.

Setting:

VA dental clinics.

Patients:

Overall, 69,610 patients met inclusion criteria, of whom 404 were randomly selected for inclusion. Adjunctive antibiotics were prescribed to 154 patients (38.1%).

Intervention:

Patients who received or did not receive an antibiotic were compared for the occurrence of postextraction infection as documented in the electronic health record. Multivariable logistic regression was performed to identify factors associated with antibiotic receipt.

Results:

There was no difference in the frequency of postextraction oral infection identified among patients who did and did not receive antibiotics (4.5% vs 3.2%; P = .59). Risk factors for postextraction infection could not be identified due to the low frequency of this outcome. Patients who received antibiotics were more likely to have a greater number of teeth extracted (aOR, 1.10; 95% CI, 1.03–1.18), documentation of acute infection at time of extraction (aOR, 3.02; 95% CI, 1.57–5.82), molar extraction (aOR, 1.78; 95% CI, 1.10–2.86) and extraction performed by an oral maxillofacial surgeon (aOR, 2.29; 95% CI, 1.44–3.58) or specialty dentist (aOR, 5.77; 95% CI, 2.05–16.19).

Conclusion:

Infectious complications occurred at a low incidence among veterans undergoing tooth extraction who did and did not receive postextraction antibiotics. These results suggest that antibiotics have a limited role in preventing postprocedural infection; however, future studies are necessary to more clearly define the role of antibiotics for this indication.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 12 , December 2021 , pp. 1431 - 1436
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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