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Ramanathan S, Evans CT, Hershow RC, Calip GS, Rowan S, Hubbard C, Suda KJ. Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study. Front Pharmacol 2024; 15:1249531. [PMID: 38292941 PMCID: PMC10824966 DOI: 10.3389/fphar.2024.1249531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Background: Antibiotics prescribed as infection prophylaxis prior to dental procedures have the potential for serious adverse drug events (ADEs). However, the extent to which guideline concordance and different dental settings are associated with ADEs from antibiotic prophylaxis is unknown. Aim: The purpose was to assess guideline concordance and antibiotic-associated ADEs and whether it differs by VA and non-VA settings. Methods: Retrospective cohort study of antibiotic prophylaxis prescribed to adults with cardiac conditions or prosthetic joints from 2015 to 2017. Multivariable logistic regression models were fit to assess the impact of ADEs, guideline concordance and dental setting. An interaction term of concordance and dental setting evaluated whether the relationship between ADEs and concordance differed by setting. Results: From 2015 to 2017, 61,124 patients with antibiotic prophylaxis were identified with 62 (0.1%) having an ADE. Of those with guideline concordance, 18 (0.09%) had an ADE while 44 (0.1%) of those with a discordant antibiotic had an ADE (unadjusted OR: 0.84, 95% CI: 0.49-1.45). Adjusted analyses showed that guideline concordance was not associated with ADEs (OR: 0.78, 95% CI: 0.25-2.46), and this relationship did not differ by dental setting (Wald χ^2 p-value for interaction = 0.601). Conclusion: Antibiotic-associated ADEs did not differ by setting or guideline concordance.
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Affiliation(s)
- Swetha Ramanathan
- School of Public Heath, University of Illinois at Chicago, Chicago, IL, United States
| | - Charlesnika T. Evans
- Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, United States
- Department of Preventive Medicine and Center for Health Services and Outcomes Research, Northwestern University of Feinberg School of Medicine, Chicago, IL, United States
| | - Ronald C. Hershow
- School of Public Heath, University of Illinois at Chicago, Chicago, IL, United States
| | - Gregory S. Calip
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Susan Rowan
- College of Dentistry, University of Illinois at Chicago, Chicago, IL, United States
| | - Colin Hubbard
- Division of Hospital Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Katie J. Suda
- Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, Pittsburgh, PA, United States
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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