Table 3.
Unadjusted Associations Between Demographic and Medical Characteristics and Unnecessary Antibiotic Prophylaxis According to the Broad Criteriaa,b
| Variable | Value | Total, No. (%) | Appropriate (Broad Criteria) (N = 256,591), No. (%) |
Inappropriate (N = 101,487), No. (%) |
Prevalence Rate Ratio (95% CI) |
P Value |
|---|---|---|---|---|---|---|
| Year | 2015 | 71,935 (20.1) | 53,752 (74.7) | 18,183 (25.3) | Reference | |
| 2016 | 74,297 (20.7) | 54,067 (72.8) | 20,230 (27.2) | 1.0772 (1.0588–1.0959) | <.0001 | |
| 2017 | 72,874 (20.4) | 51,041 (70) | 21,833 (30) | 1.1853 (1.1656–1.2053) | <.0001 | |
| 2018 | 70,651 (19.7) | 49,577 (70.2) | 21,074 (29.8) | 1.1801 (1.1603–1.2002) | <.0001 | |
| 2019 | 68,321 (19.1) | 48,154 (70.5) | 20,167 (29.5) | 1.1678 (1.148–1.1879) | <.0001 | |
| Gender | Male | 325,763 (91) | 233,164 (71.6) | 92,599 (28.4) | Reference | |
| Female | 32,315 (9) | 23,427 (72.5) | 8,888 (27.5) | 0.9676 (0.9498–0.9857) | .0005 | |
| Race | White | 241,747 (67.5) | 173,994 (72) | 67,753 (28) | Reference | |
| Black | 89,475 (25) | 64,039 (71.6) | 25,436 (28.4) | 1.0143 (1.002–1.0268) | .0226 | |
| Native American/Alaskan | 2,992 (0.8) | 2,125 (71) | 867 (29) | 1.0339 (0.9772–1.094) | .2515 | |
| Native Hawaiian/Pacific Islander | 3,759 (1) | 2,687 (71.5) | 1,072 (28.5) | 1.0175 (0.9669–1.0708) | .5101 | |
| Asian | 3,978 (1.1) | 2,762 (69.4) | 1,216 (30.6) | 1.0907 (1.0403–1.1435) | .0005 | |
| Multiracial | 4,064 (1.1) | 2,983 (73.4) | 1,081 (26.6) | 0.9491 (0.9015–0.9992) | .0446 | |
| Missing | 12,063 (3.4) | 8,001 (66.3) | 4,062 (33.7) | |||
| Ethnicity | Non-Latine | 321,821 (89.9) | 230,000 (71.5) | 91,821 (28.5) | Reference | |
| Latine | 29,268 (8.2) | 21,837 (74.6) | 7,431 (25.4) | 0.8899 (0.8719–0.9082) | <.0001 | |
| Missing | 6,989 (2) | 4,754 (68) | 2,235 (32) | |||
| Age | 18–44 y | 38,447 (10.7) | 25,219 (65.6) | 13,228 (34.4) | Reference | |
| 45–64 y | 128,429 (35.9) | 92,231 (71.8) | 36,198 (28.2) | 0.8192 (0.8059–0.8327) | <.0001 | |
| ≥65 y | 191,202 (53.4) | 139,141 (72.8) | 52,061 (27.2) | 0.7914 (0.7791–0.8038) | <.0001 | |
| Complexity | 1a/1b/1c | 308,582 (86.2) | 222,542 (72.1) | 86,040 (27.9) | Reference | |
| 2 | 22,933 (6.4) | 16,115 (70.3) | 6,818 (29.7) | 1.0663 (1.0444–1.0886) | <.0001 | |
| 3 | 26,563 (7.4) | 17,934 (67.5) | 8,629 (32.5) | 1.1651 (1.144–1.1865) | <.0001 | |
| Region | Northeast | 51,817 (14.5) | 36,845 (71.1) | 14,972 (28.9) | Reference | |
| Midwest | 67,002 (18.7) | 48,882 (73) | 18,120 (27) | 0.936 (0.9189–0.9533) | <.0001 | |
| South | 160,298 (44.8) | 114,718 (71.6) | 45,580 (28.4) | 0.9841 (0.9689–0.9996) | .0446 | |
| West | 72,967 (20.4) | 51,386 (70.4) | 21,581 (29.6) | 1.0236 (1.0058–1.0417) | .0091 | |
| US Territories | 5,994 (1.7) | 4,760 (79.4) | 1,234 (20.6) | 0.7125 (0.6767–0.7502) | <.0001 | |
| Smoking | Never smoked | 68,945 (19.3) | 49,964 (72.5) | 18,981 (27.5) | Reference | |
| Current smoker | 104,679 (29.2) | 79,293 (75.7) | 25,386 (24.3) | 0.8809 (0.8668–0.8952) | <.0001 | |
| Past smoker | 59,826 (16.7) | 44,724 (74.8) | 15,102 (25.2) | 0.9169 (0.9002–0.9339) | <.0001 | |
| Missing | 124,628 (34.8) | 82,610 (66.3) | 42,018 (33.7) | |||
| Patient characteristic | Friday visit | 61,730 (17.2) | 43,390 (70.3) | 18,340 (29.7) | 1.0589 (1.0448–1.0732) | <.0001 |
| Cardiac condition | 60,428 (16.9) | 53,442 (88.4) | 6,986 (11.6) | 0.3641 (0.356–0.3725) | <.0001 | |
| Prosthetic condition | 92,522 (25.8) | 66,818 (72.2) | 25,704 (27.8) | 0.9735 (0.9619–0.9853) | <.0001 | |
| Immunocompromised | 242,093 (67.6) | 217,912 (90) | 24,181 (10) | 0.1499 (0.148–0.1518) | <.0001 | |
| History of pulpitis | 200,744 (56.1) | 146,237 (72.8) | 54,507 (27.2) | 0.9093 (0.8999–0.9189) | <.0001 | |
| History of periodontitis | 28,117 (7.9) | 20,615 (73.3) | 7,502 (26.7) | 0.9367 (0.9181–0.9558) | <.0001 | |
| Elixhauser index | 0 | 121,110 (33.8) | 69,682 (57.5) | 51,428 (42.5) | Reference | |
| 1 | 97,805 (27.3) | 71,398 (73) | 26,407 (27) | 0.6358 (0.6281–0.6436) | <.0001 | |
| 2 | 139,163 (38.9) | 115,511 (83) | 23,652 (17) | 0.4002 (0.3949–0.4056) | <.0001 | |
| Charlson score | 0 | 267,437 (74.7) | 183,725 (68.7) | 83,712 (31.3) | Reference | |
| 1 | 25,775 (7.2) | 19,903 (77.2) | 5,872 (22.8) | 0.7278 (0.7111–0.7449) | <.0001 | |
| 2 or more | 64,866 (18.1) | 52,963 (81.6) | 11,903 (18.4) | 0.5862 (0.5763–0.5964) | <.0001 | |
| Extraction | No extraction | 253,724 (70.9) | 166,316 (65.5) | 87,408 (34.5) | Reference | |
| Simple extraction | 51,393 (14.4) | 37,314 (72.6) | 14,079 (27.4) | 0.7952 (0.7833–0.8073) | <.0001 | |
| Surgical extraction | 52,961 (14.8) | 52,961 (100) | 0 (0) | … | <.0001 | |
| Invasive visit | Routine | 125,091 (34.9) | 78,108 (62.4) | 46,983 (37.6) | Reference | |
| Mildly invasive | 40,824 (11.4) | 19,027 (46.6) | 21,797 (53.4) | 1.4216 (1.4053–1.4381) | <.0001 | |
| Invasive | 192,163 (53.7) | 159,456 (83) | 32,707 (17) | 0.4532 (0.4477–0.4587) | <.0001 | |
| Amoxicillin | 267,826 (74.8) | 192414 (71.8) | 75,412 (28.2) | 0.9746 (0.9631–0.9862) | <.0001 | |
| Amoxicillin/ clavulanic acid |
18,269 (5.1) | 13,222 (72.4) | 5,047 (27.6) | 0.9734 (0.9503–0.9971) | .0279 | |
| Clindamycin | 57,999 (16.2) | 42,024 (72.5) | 15,975 (27.5) | 0.9666 (0.9528–0.9805) | <.0001 | |
| Cephalexin | 2,888 (0.8) | 1,901 (65.8) | 987 (34.2) | 1.2079 (1.1479–1.2709) | <.0001 | |
| Penicillin | 23,197 (6.5) | 16,118 (69.5) | 7,079 (30.5) | 1.0825 (1.0609–1.1045) | <.0001 | |
| Doxycycline | 2,494 (0.7) | 1,651 (66.2) | 843 (33.8) | 1.1942 (1.1301–1.262) | <.0001 | |
| Metronidazole | 2,385 (0.7) | 1,584 (66.4) | 801 (33.6) | 1.1865 (1.1211–1.2556) | <.0001 | |
| Other antibiotic | 529 (0.1) | 355 (67.1) | 174 (32.9) | 1.1608 (1.0277–1.3112) | .0232 |
a
Cardiac condition or surgical extraction/tooth implant or immunocompromised + gingival manipulation).
b
The following variables were nonsignificant and were removed from the table: rural, history of acute apical abscess, azithromycin, and fluoroquinolone. The complete tables with the Charlson scores and disease categories are included in Supplementary Table 4 (online).