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Recommendations for dentists, other health care providers
“Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation,” stated the World Health Organization in a report published April 29.
Already, drug-resistant diseases cause at least 700,000 deaths worldwide each year, but “if no action is taken,” that figure could increase to 10 million globally per year by 2050, overtaking diabetes, heart disease and cancer as the leading cause of death in humans, the report states. In the U.S., at least 2 million people each year are diagnosed with an antibiotic-resistant infection and, of these, approximately 23,000 die, according to the Centers for Disease Control and Prevention. In California, the respective annual numbers are 260,000 illnesses and 3,000 deaths.
Inappropriate use and overuse of antibiotics are the primary drivers of antibiotic resistance and are associated with C. difficile infections and increased emergency department visits for adverse events. Antibiotic-resistant infections are more difficult to treat and are linked to increased morbidity and mortality. Few antibiotics remain for treating resistant infections, and when new antibiotics are introduced, resistant microbes emerge faster — in as little as a year.
Dentists prescribe about 10% of all antibiotics in outpatient settings, according to a 2017 CDE report, and consequently play an important role in the effort to address antibiotic resistance.
The CDC recommends actions for health care providers, government health officials, pharmaceutical companies and agricultural producers. For health care providers, the recommendation is to increase the judicious use of antibiotics and improve infection prevention and control.
The December 2018 issue of the Journal of the California Dental Association spotlights antibiotic stewardship in dentistry with the feature article by Peter L. Jacobsen, PhD, DDS,
examining the four core elements of antibiotic stewardship (commitment; action for policy and practice; tracking and reporting; and education and expertise). Also included are considerations for optimal antibiotic prescribing that encompass pretreatment, prescribing and staff education. A table is included as a guide for dental professionals who prescribe antibiotics in outpatient settings for certain common conditions.
Dentists and other health care providers can also participate in U.S. Antibiotic Awareness Week, which takes place every November. The CDC, in collaboration with state-based programs and nonprofit and for-profit partners, initiated the annual observance to raise awareness of the threat of antibiotic resistance and the importance of appropriate antibiotic prescribing. CDA will remind dentists about USAAW 2019, set for Nov. 18-24, in early fall. More information, including a provider toolkit, is available now.
Read the article “The Four Core Elements of Antibiotic Stewardship in Dentistry” in the December 2018 CDA Journal. The WHO report is available on the organization’s website.