Table 1.
Unadjusted Associations Between Demographic and Medical Characteristics and Unnecessary Antibiotic Prophylaxis Prescriptions According to the Narrow Criteria a, b
| Variable | Value | Total, No. (%) |
Appropriate (Narrow Criteria) (N = 53,442), No. (%) |
Unnecessary (N = 304,636), No. (%) |
Prevalence Rate Ratio (95% CI) |
P Value |
|---|---|---|---|---|---|---|
| Year | 2015 | 71,935 (20.1) | 11,479 (16) | 60,456 (84) | Reference | |
| 2016 | 74,297 (20.7) | 11,502 (15.5) | 62,795 (84.5) | 1.0057 (1.0012–1.0101) | .0124 | |
| 2017 | 72,874 (20.4) | 10,914 (15) | 61,960 (85) | 1.0117 (1.0072–1.0161) | <.0001 | |
| 2018 | 70,651 (19.7) | 10,017 (14.2) | 60,634 (85.8) | 1.0212 (1.0167–1.0256) | <.0001 | |
| 2019 | 68,321 (19.1) | 9,530 (13.9) | 58,791 (86.1) | 1.0239 (1.0194–1.0284) | <.0001 | |
| Gender | Male | 325,763 (91) | 49,722 (15.3) | 276,041 (84.7) | Reference | |
| Female | 32,315 (9) | 3,720 (11.5) | 28,595 (88.5) | 1.0443 (1.0399–1.0487) | <.0001 | |
| Race | White | 241,747 (67.5) | 38,810 (16.1) | 202,937 (83.9) | Reference | |
| Black | 89,475 (25) | 11,303 (12.6) | 78,172 (87.4) | 1.0408 (1.0376–1.0439) | <.0001 | |
| Native American/Alaskan | 2,992 (0.8) | 423 (14.1) | 2,569 (85.9) | 1.0228 (1.008–1.0379) | .0043 | |
| Native Hawaiian/Pacific Islander | 3,759 (1) | 507 (13.5) | 3,252 (86.5) | 1.0306 (1.0175–1.0438) | <.0001 | |
| Asian | 3,978 (1.1) | 422 (10.6) | 3,556 (89.4) | 1.0649 (1.0534–1.0765) | <.0001 | |
| Multiracial | 4,064 (1.1) | 540 (13.3) | 3,524 (86.7) | 1.033 (1.0205–1.0456) | <.0001 | |
| Missing | 12,063 (3.4) | 1,437 (11.9) | 10,626 (88.1) | |||
| Ethnicity | Non-Latine | 32,1821 (89.9) | 48,795 (15.2) | 273,026 (84.8) | Reference | |
| Latine | 29,268 (8.2) | 3,688 (12.6) | 25,580 (87.4) | 1.0302 (1.0255–1.0349) | <.0001 | |
| Missing | 6,989 (2) | 959 (13.7) | 6,030 (86.3) | |||
| Age | 18–44 y | 38,447 (10.7) | 1,824 (4.7) | 36,623 (95.3) | Reference | |
| 45–64 y | 128,429 (35.9) | 14,676 (11.4) | 113,753 (88.6) | 0.9298 (0.9271–0.9326) | <.0001 | |
| ≥65 y | 191,202 (53.4) | 36,942 (19.3) | 154,260 (80.7) | 0.847 (0.8443–0.8496) | <.0001 | |
| Rural | 40,025 (11.2) | 6,635 (16.6) | 33,390 (83.4) | 0.9778 (0.9733–0.9823) | <.0001 | |
| Missing | 1,1931 (3.3) | 1,866 (15.6) | 10,065 (84.4) | |||
| Complexity | 1a/1b/1c | 308,582 (86.2) | 45,357 (14.7) | 263,225 (85.3) | Reference | |
| 2 | 22,933 (6.4) | 3,753 (16.4) | 19180 (83.6) | 0.9805 (0.9747–0.9863) | <.0001 | |
| 3 | 26,563 (7.4) | 4,332 (16.3) | 22,231 (83.7) | 0.9811 (0.9757–0.9865) | <.0001 | |
| Region | Northeast | 51817 (14.5) | 7848 (15.1) | 43969 (84.9) | Reference | |
| Midwest | 67,002 (18.7) | 11,950 (17.8) | 55,052 (82.2) | 0.9683 (0.9634–0.9732) | <.0001 | |
| South | 160,298 (44.8) | 22,454 (14) | 137,844 (86) | 1.0134 (1.0092–1.0176) | <.0001 | |
| West | 72,967 (20.4) | 10,301 (14.1) | 62,666 (85.9) | 1.0121 (1.0074–1.0169) | <.0001 | |
| US territories | 5,994 (1.7) | 889 (14.8) | 5,105 (85.2) | 1.0037 (0.9925–1.015) | .5297 | |
| Smoking | Never smoked | 68,945 (19.3) | 10,677 (15.5) | 58,268 (84.5) | Reference | |
| Current smoker | 10,4679 (29.2) | 15,160 (14.5) | 89,519 (85.5) | 1.0119 (1.0078–1.016) | <.0001 | |
| Past smoker | 59,826 (16.7) | 10,762 (18) | 49,064 (82) | 0.9704 (0.9656–0.9752) | <.0001 | |
| Missing | 124,628 (34.8) | 16,843 (13.5) | 107,785 (86.5) | |||
| Patient characteristic | Friday visit | 61,730 (17.2) | 8,887 (14.4) | 52,843 (85.6) | 1.0075 (1.0039–1.0111) | <.0001 |
| Cardiac condition | 60,428 (16.9) | 53,442 (88.4) | 6,986 (11.6) | 0.1156 (0.1131–0.1182) | <.0001 | |
| Prosthetic condition | 92,522 (25.8) | 17,143 (18.5) | 75,379 (81.5) | 0.9437 (0.9405–0.9469) | <.0001 | |
| Immunocompromised | 242,093 (67.6) | 42,402 (17.5) | 199,691 (82.5) | 0.9116 (0.9092–0.914) | <.0001 | |
| History of pulpitis | 200,744 (56.1) | 31,437 (15.7) | 169,307 (84.3) | 0.9805 (0.9779–0.9832) | <.0001 | |
| History of periodontitis | 28,117 (7.9) | 4,365 (15.5) | 23,752 (84.5) | 0.9924 (0.9872–0.9975) | .0034 | |
| History of acute apical abscess | 11,132 (3.1) | 1,508 (13.5) | 9,624 (86.5) | 1.0167 (1.0091–1.0244) | <.0001 | |
| Elixhauser index | 0 | 121,110 (33.8) | 9,436 (7.8) | 111,674 (92.2) | Reference | |
| 1 | 97,805 (27.3) | 12,906 (13.2) | 84,899 (86.8) | 0.9414 (0.9386–0.9442) | <.0001 | |
| 2 | 139,163 (38.9) | 31,100 (22.3) | 108,063 (77.7) | 0.8421 (0.8394–0.8449) | <.0001 | |
| Extraction | No extraction | 253,724 (70.9) | 36,794 (14.5) | 216,930 (85.5) | Reference | |
| Simple extraction | 51,393 (14.4) | 8,327 (16.2) | 43,066 (83.8) | 0.9801 (0.9761–0.9842) | <.0001 | |
| Surgical extraction | 52,961 (14.8) | 8,321 (15.7) | 44,640 (84.3) | 0.9858 (0.9819–0.9898) | <.0001 | |
| Invasive dental visit | Routine | 125,091 (34.9) | 19,497 (15.6) | 105,594 (84.4) | Reference | |
| Mildly invasive | 40,824 (11.4) | 5,657 (13.9) | 35,167 (86.1) | 1.0205 (1.0158–1.0252) | <.0001 | |
| Invasive | 192,163 (53.7) | 28,288 (14.7) | 163,875 (85.3) | 1.0103 (1.0072–1.0133) | <.0001 | |
| Amoxicillin/ Clavulanic acid |
18,269 (5.1) | 2,178 (11.9) | 16,091 (88.1) | 1.0373 (1.0316–1.043) | <.0001 | |
| Clindamycin | 57,999 (16.2) | 9,581 (16.5) | 48,418 (83.5) | 0.9777 (0.9739–0.9815) | <.0001 | |
| Azithromycin | 3,937 (1.1) | 525 (13.3) | 3,412 (86.7) | 1.0189 (1.0064–1.0315) | .0046 | |
| Penicillin | 23,197 (6.5) | 2,840 (12.2) | 20,357 (87.8) | 1.0338 (1.0286–1.039) | <.0001 | |
| Doxycycline | 2,494 (0.7) | 313 (12.6) | 2,181 (87.4) | 1.0281 (1.0129–1.0436) | .0007 | |
| Metronidazole | 2,385 (0.7) | 269 (11.3) | 2,116 (88.7) | 1.0432 (1.0283–1.0583) | <.0001 |
a
Cardiac condition + gingival manipulation.
b
The following variables were nonsignificant and removed from the table: amoxicillin, cephalexin, fluoroquinolone, and other antibiotic. The complete tables with the Charlson scores and disease categories are included in Supplementary Table 3 (online). Ceftriaxone was not prescribed during the study period. Where not indicated, the reference group is in absence of that condition. For example, the reference group for Friday visit are visits occurring on all other days and the reference group for clindamycin are non–clindamycin antibiotics.