Providers’ Perceptions of Antibiotic Prophylaxis in Dental Practice for Preventing Prosthetic Joint Infections

Introduction: Dental antimicrobial prescribing accounts for about 25% of the total oral antibiotics dispensed in the United States; therefore, responsible use of antibiotics in dentistry is important to reduce risk of antimicrobial resistance. However, there is a lack of consistency in the use of antibiotic prophylaxis to prevent prosthetic joint infections (PJI). One contributing factor is the multiple clinical practice guidelines with contradictory recommendations. Additionally, several research projects studied the prescribers’ perceptions of the antibiotic prophylaxis, but few attempts have been made to assess the patients’ perceptions. Methods: In October 2020, a survey was disseminated to 65 dental providers in three regions of North Carolina. The survey collected the demographic information and assessed the providers’ perceptions of antibiotic prophylaxis as well as their prescribing practice of antibiotic prophylaxis. Survey results were analyzed by descriptive statistics and correlation analysis. Results: In total, 11 responses were received. The overall response rate was 17%. More than half of the surveyed dentists believed that there was a connection between dental care and PJI (50%), and that PJI may be induced by daily dental cleaning activities (70%). Similarly, 50% dental providers reported that they had prescribed antibiotic prophylaxis for patients with total joint replacement (TJR). The most common reasons they prescribed antibiotic prophylaxis were guideline instructions and risk of legal liability. None of the demographic factors (gender, age, years of training, practice specialty) showed association with dentists’ perception of antibiotic prophylaxis prior to dental procedures for patients with prosthetic joints or the practice of it. Conclusion: While most dental providers recognize the consequences of overuse of antibiotics, the antibiotic prophylactic regimen is still prevalent regardless of the dental provider’ gender, age, training, or specialty. Discrepancy remains regarding antibiotic prophylaxis protocols used in dentistry and more research regarding the protocols is needed. Our study is exploratory and future studies with larger samples are encouraged.Doctor of Pharmac