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Is Clindamycin a Good Antibiotic for Dental Infections? Therapeutics Initiative (University of British Columbia)

Description

Background: Clindamycin is frequently prescribed by dentists in British Columbia (BC) for dental infections despite its significant propensity for harm, particularly in causing Clostridioides difficile colitis. Clindamycin accounts for 12% of antibiotic prescriptions from BC dentists, compared to 5% in Australia and a mere 0.5% in the UK. These disparities cannot be explained solely by differences in dental health. Aims: This Therapeutics Letter highlights the risks associated with clindamycin use in dental practice, provides guidance on antibiotic use in dental infections, and recommends alternatives for patients with reported penicillin allergies. Recommendations: Dentists are advised against using clindamycin for prophylaxis or initial treatment of dental infections due to its high risk of causing Clostridioides difficile colitis, increased mortality compared to amoxicillin, and potential for severe adverse reactions. Given the high prevalence of reported penicillin allergies, dentists are encouraged to consider cefuroxime as a safe alternative for most patients. The Bugs & Drugs program offers updated guidance for pre-operative dental prophylaxis and treatment of active infections, aligned with the guidance from the American Dental Association (ADA) and other authoritative bodies.

Item Metadata

Title
Is Clindamycin a Good Antibiotic for Dental Infections?
Alternate Title
Rethink clindamycin for dental patient safety; Therapeutics Letter 148
Creator
Therapeutics Initiative (University of British Columbia)
Date Issued
2024-04
Description
Background: Clindamycin is frequently prescribed by dentists in British Columbia (BC) for dental infections despite its significant propensity for harm, particularly in causing Clostridioides difficile colitis. Clindamycin accounts for 12% of antibiotic prescriptions from BC dentists, compared to 5% in Australia and a mere 0.5% in the UK. These disparities cannot be explained solely by differences in dental health. Aims: This Therapeutics Letter highlights the risks associated with clindamycin use in dental practice, provides guidance on antibiotic use in dental infections, and recommends alternatives for patients with reported penicillin allergies. Recommendations: Dentists are advised against using clindamycin for prophylaxis or initial treatment of dental infections due to its high risk of causing Clostridioides difficile colitis, increased mortality compared to amoxicillin, and potential for severe adverse reactions. Given the high prevalence of reported penicillin allergies, dentists are encouraged to consider cefuroxime as a safe alternative for most patients. The Bugs & Drugs program offers updated guidance for pre-operative dental prophylaxis and treatment of active infections, aligned with the guidance from the American Dental Association (ADA) and other authoritative bodies.
Subject
Anti-Bacterial Agents; Cefuroxime; Clindamycin; Clostridium Infections; Dental Infection; Drug-Related Side Effects and Adverse Reactions; Patient Safety
Genre
Other
Type
Text
Language
eng
Notes
The UBC TI is funded by the BC Ministry of Health to provide evidence-based information about drug therapy. We neither formulate nor adjudicate provincial drug policies.
Date Available
2024-09-25
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0445449
URI
http://hdl.handle.net/2429/89290
Affiliation
Medicine, Faculty of; Anesthesiology, Pharmacology and Therapeutics, Department of
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International