Jessina C. McGregor PhD, Geneva M. Wilson MPH, PhD, Gretchen Gibson DDS, MPH, M. Marianne Jurasic DMD, MPH, Charlesnika T. Evans MPH, PhD, Katie J. Suda PharmD, M.S., FCCP
{"title":"抗生素预处理对拔牙术后并发症的影响","authors":"Jessina C. McGregor PhD, Geneva M. Wilson MPH, PhD, Gretchen Gibson DDS, MPH, M. Marianne Jurasic DMD, MPH, Charlesnika T. Evans MPH, PhD, Katie J. Suda PharmD, M.S., FCCP","doi":"10.1111/jphd.12634","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted a retrospective cohort study of patients undergoing dental extractions in 2015–2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (<i>p</i> = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13–1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92–1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83–1.30).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use.</p>\n </section>\n </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"84 4","pages":"343-350"},"PeriodicalIF":1.8000,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619531/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effect of antibiotic premedication on postoperative complications following dental extractions\",\"authors\":\"Jessina C. McGregor PhD, Geneva M. Wilson MPH, PhD, Gretchen Gibson DDS, MPH, M. Marianne Jurasic DMD, MPH, Charlesnika T. Evans MPH, PhD, Katie J. Suda PharmD, M.S., FCCP\",\"doi\":\"10.1111/jphd.12634\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We conducted a retrospective cohort study of patients undergoing dental extractions in 2015–2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (<i>p</i> = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13–1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92–1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83–1.30).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. 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The effect of antibiotic premedication on postoperative complications following dental extractions
Objectives
We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System.
Methods
We conducted a retrospective cohort study of patients undergoing dental extractions in 2015–2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome.
Results
Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (p = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13–1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92–1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83–1.30).
Conclusions
In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use.
期刊介绍：
The Journal of Public Health Dentistry is devoted to the advancement of public health dentistry through the exploration of related research, practice, and policy developments. Three main types of articles are published: original research articles that provide a significant contribution to knowledge in the breadth of dental public health, including oral epidemiology, dental health services, the behavioral sciences, and the public health practice areas of assessment, policy development, and assurance; methods articles that report the development and testing of new approaches to research design, data collection and analysis, or the delivery of public health services; and review articles that synthesize previous research in the discipline and provide guidance to others conducting research as well as to policy makers, managers, and other dental public health practitioners.
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