title: Antibiotic-associated diarrhea and the older dental patient: how do dentists respond?
abstract: BACKGROUND
  Gastrointestinal complications from antibiotic use, including Clostridium difficile infection (CDI), can have significant morbidity, especially among older patients. This descriptive study surveyed dentists to find out how they would respond to a patient with signs indicating potential CDI.
  
  
  METHODS
  A survey on prescribing medications for older patients was mailed to 1,000 dentists in New Jersey. Questions were asked regarding antibiotic selection, probiotic use, and approach to a patient scenario of diarrhea after antibiotic use.
  
  
  RESULTS
  Respondents chose amoxicillin most frequently as an antibiotic, and clindamycin if penicillin allergy. When informed their patients had diarrhea, 64.5% advised them to stop the antibiotic. If the patient continued to have diarrhea on follow-up, 75.5% contacted the patient's physician. Most (61.6%) do not prescribe probiotics prophylactically.
  
  
  CONCLUSIONS
  Most dentists respond appropriately to antibiotic-associated diarrhea in advising to stop the antibiotic, and seeking physician involvement if no improvement, but there are still many who make recommendations that could delay appropriate care. Dentists may wish to learn more about benefits of probiotics.
authors: Previously, Geriatric Dentistry Fellow, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Currently, Clinical Instructor, Rutgers School of Dental Medicine.
authors: Samuel R
authors: SR
authors: Zwetchkenbaum
authors: Assistant Professor- Geriatric Medicine, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine.
authors: Kevin J
authors: KJ
authors: Overbeck
authors: Assistant Professor- Medicine, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey.
authors: Sherry C
authors: SC
authors: Pomerantz
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D016360:Clostridioides difficile; D003657:Decision Making; D016321:Dental Care for Aged; D003967:Diarrhea / Q000139:chemically induced* / Q000382:microbiology / Q000517:prevention & control*; D004761:Enterocolitis, Pseudomembranous / Q000139:chemically induced* / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*
chemical_list: D000900:Anti-Bacterial Agents
keywords: geriatric dentistry; pharmacology