Dentists sometimes prescribe the antibiotic drug clindamycin in British Columbia for dental infections, although it can cause serious harm. Sometimes it is even given to prevent infection before dental work is done.
This Therapeutics Letter stresses patient safety when choosing the best antibiotic for dental care.
Why is clindamycin usually not the best drug for dental infections?
Most dental infections come from bacteria in the mouth. Clindamycin is not any better than other antibiotics at treating these dental infections and can cause more harms.
Recent research shows that other antibiotics are just as good at healing dental infections.
What are the risks of using clindamycin?
Clindamycin can cause diarrhea, stomach inflammation, and other problems. The most serious risk is developing Clostridioides difficile colitis.
This is a severe infection of the colon. Studies have found that clindamycin is much more likely to cause this infection than other antibiotics. Even a single dose can lead to serious reactions that can be life-threatening.
What about patients who say they are allergic to penicillin?
Many patients believe or were told as children that they are allergic to penicillin. Many studies have shown they may not be truly allergic or have outgrown the allergy.
Dentists should ask questions about allergies and consider using cefuroxime instead, which is safe for most people with a penicillin allergy.
Antibiotics are overused in dentistry
Research shows that antibiotics may be prescribed before dental procedures to try to make sure an infection does not start.
Guidelines recommend against using antibiotics for this purpose. Whether antibiotics are really needed to prevent infections before dental work in patients with heart conditions has also been questioned.
Choosing the right antibiotic
The Bugs & Drugs program www.bugsanddrugs.org updates advice for antibiotic use in dental care.
Dentists should avoid using clindamycin as the first choice for dental infections. Safer alternatives, like cefuroxime, should be used especially for patients with penicillin allergies.
Conclusion
To protect patients from possible harm, clindamycin for dental infections is not a good choice. Other antibiotics should be used, and only when necessary.
For more guidance, visit the Bugs & Drugs website.
