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Precautionary (prophylactic) antibiotics prescribed by dentists are unnecessary 81% of the time, according to a study published today. Antibiotics prescribed when not warranted expose patients to the risk of side effects unnecessarily and also contribute to the problem of antibiotic resistance -- bacteria evolving to make the drugs ineffective.

Researchers used a US national health care claims database to examine nearly 170,000 dentist-written antibiotic prescriptions from 2011 to 2015. The prescriptions involved more than 90,000 patients, 57 percent female, with a median age of 63. Less than 21 percent of those people had a cardiac condition that made an antibiotic prescription recommended under medical guidelines. Among patients who filled prescriptions for unnecessary antibiotics, clindamycin was the most common drug, and joint implants were the most typical reason they were prescribed.

"Dental providers are very thoughtful when they develop care plans for their patients and there are many factors that inform dentists' recommendations, but this study shows that there is an opportunity for dentists to reevaluate if necessary," said Susan Rowan of the Illinois-Chicago College of Dentistry. "I think dental providers should view this study, which is the first to look at preventive antibiotic prescribing for dental procedures, as a powerful call to action, not a rebuke."
 
Outline the main issues raised

(Reference: Adapted from: https://www.sciencedaily.com/releases/2019/05/190531143107.htm)

Example Candidate Response

The article focuses on the unnecessary prescription of antibiotics by dentists in the US. Prophylactic antibiotics being used incorrectly is an issue - both in terms of safety and in the risk of increased antibiotic resistance in bacteria.
 
The study should act as a cue for dentists to re-evaulate their prescription of prophylactic antibiotics. It is the first such study, and therefore breaking new ground.

Much like with painkillers, there may well be a feeling amongst patients that they ‘need’ antibiotics, meaning that they may claim to be unsatisfied with their care if they do not receive them.
 
This is a significant issue in a private healthcare setting in which dentists must ‘compete’ for patients.

One is left to ponder whether much clearer rulings are needed in order to reduce this problem, as perhaps clinicians’ senses of what the ‘best’ action is are being subverted by their need to retain patients.