Evaluation of patients labeled with a penicillin allergy to promote antimicrobial stewardship in dental practice.

Background: Approximately 10% of the US population self-reports a penicillin allergy history or are labeled as penicillin allergic. However, from 90% through 99% of these patients are not allergic on formal evaluation.

Case Description: Patients labeled as penicillin allergic receive broader-spectrum and sometimes less-effective antibiotics, thereby contributing to increased treatment failures, antibiotic resistance, and adverse drug reactions.

Appropriate antibiotic use in dentistry: a review of the literature and clinical recommendations.

This article reviews the latest evidence on the use of antibiotics in dentistry, beginning with the risks of antibiotic use, which include Clostridioides difficile infection and antimicrobial resistance. The article then reviews the clinical practice guidelines for antibiotic prophylaxis for patients with prosthetic joints or at high risk for infective endocarditis. In the absence of established guidelines, the discussion also examines the published evidence on best practices for antibiotic prophylaxis with regard to other medical conditions (eg, kidney disease, cancer, or immunosuppression), dental extractions, minor oral surgical procedures, and implant placement, offering sample prescriptions for these situations.

The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners--a report of the American Dental Association Council on Scientific Affairs.

Background: A panel of experts (the 2014 Panel) convened by the American Dental Association Council on Scientific Affairs developed an evidence-based clinical practice guideline (CPG) on the use of prophylactic antibiotics in patients with prosthetic joints who are undergoing dental procedures. This CPG is intended to clarify the "Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-based Guideline and Evidence Report," which was developed and published by the American Academy of Orthopaedic Surgeons and the American Dental Association (the 2012 Panel).

Types Of Studies Reviewed: The 2014 Panel based the current CPG on literature search results and direct evidence contained in the comprehensive systematic review published by the 2012 Panel, as well as the results from an updated literature search.