Most of the antibiotics prescribed by dentists in the United States are unnecessary and go against clinical guidelines, according to a study published online last week in JAMA Network Open.

That finding is “concerning,” write the authors of the study, given the role that unnecessary antibiotics are playing in the development of antibiotic-resistant “superbugs,” a growing and urgent public health problem both globally and in the United States.

As background information in the study points out, dentists prescribe a significant proportion  — about 10 percent — of antibiotics in the United States. They are also the top prescribers of clindamycin, the antibiotic most associated with potentially life-threatening C. difficile infections.

In 2017, University of Minnesota researchers reported that 15 percent of Minnesota patients diagnosed with C. difficile infections between 2009 and 2015 had received an antibiotic prescription from their dentist prior to developing the infection, and at least half of those prescriptions were for clindamycin.

Each year, about 500,000 Americans develop C. difficile infections, and about 15,000 die from the illness, “making it a substantial cause of infectious disease death in the United States,” according to the Centers for Disease Control and Prevention.

The authors of the new study say their findings underscore the need to include dentists in efforts to reduce the overprescribing of antibiotics.

“I think of dentists as being part of my primary care,” Katie Suda, the study’s lead author and an associate professor of pharmacy at the University of Illinois at Chicago, (UIC) told Chris Dall, a reporter for the University of Minnesota’s Center for Infectious Disease Resistance and Policy (CIDRAP). “They need to be included in this conversation around antibiotic use and prescribing and antibiotic stewardship.”

Sudra and her colleagues express optimism that the situation can be turned around. Earlier this year, the same team of researchers reported on the success of an antibiotic stewardship “intervention” at a UIC dental clinic.

“There has been some success with medical providers, especially pediatricians, in decreasing antibiotic prescribing,” she told CIDRAP News.

“Perhaps some of those strategies can work for dentists,” she added.