Ramanathan Swetha, Evans Charlesnika T, Hershow Ronald C, Calip Gregory S, Rowan Susan, Hubbard Colin, Suda Katie J
School of Public Heath, University of Illinois at Chicago, Chicago, IL, United States.
Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, United States.
Front Pharmacol. 2024 Jan 16;15:1249531. doi: 10.3389/fphar.2024.1249531. eCollection 2024.
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. The purpose was to assess guideline concordance and antibiotic-associated ADEs and whether it differs by VA and non-VA settings. 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. 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 -value for interaction = 0.601). Antibiotic-associated ADEs did not differ by setting or guideline concordance.
在牙科手术前作为感染预防措施开具的抗生素有引发严重药物不良事件（ADEs）的可能性。然而，指南遵循程度以及不同牙科环境与抗生素预防导致的ADEs之间的关联程度尚不清楚。目的是评估指南遵循情况和抗生素相关的ADEs，以及它们在退伍军人事务部（VA）和非VA环境中是否存在差异。对2015年至2017年为患有心脏疾病或人工关节的成年人开具的抗生素预防措施进行回顾性队列研究。采用多变量逻辑回归模型来评估ADEs、指南遵循情况和牙科环境的影响。一致性和牙科环境的交互项用于评估ADEs与一致性之间的关系在不同环境中是否存在差异。2015年至2017年，共识别出61124例接受抗生素预防的患者，其中62例（0.1%）发生了ADEs。在遵循指南的患者中，18例（0.09%）发生了ADEs，而在抗生素使用不遵循指南的患者中，44例（0.1%）发生了ADEs（未调整的比值比：0.84，95%置信区间：0.49 - 1.45）。调整后的分析表明，指南遵循情况与ADEs无关（比值比：0.78，95%置信区间：0.25 - 2.46），并且这种关系在不同牙科环境中没有差异（交互作用的Wald χ²值 = 0.601）。抗生素相关的ADEs在不同环境或指南遵循情况方面没有差异。
