Thornhill, M.H. orcid.org/0000-0003-0681-4083, Dayer, M.J., Prendergast, B. et al. (3 more authors) (2015) Incidence and nature of adverse reactions to antibiotics used as endocarditis prophylaxis. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 70 (8). pp. 2382-2388. ISSN 0305-7453
Abstract
Objectives Antibiotic prophylaxis (AP) administration prior to invasive dental procedures has been a leading focus of infective endocarditis prevention. However, there have been long-standing concerns about the risk of adverse drug reactions as a result of this practice. The objective of this study was to identify the incidence and nature of adverse reactions to amoxicillin and clindamycin prophylaxis to prevent infective endocarditis.
Methods We obtained AP prescribing data for England from January 2004 to March 2014 from the NHS Business Services Authority, and adverse drug reaction data from the Medicines and Healthcare Products Regulatory Agency's Yellow Card reporting scheme for prescriptions of the standard AP protocol of a single 3 g oral dose of amoxicillin or a single 600 mg oral dose of clindamycin for those allergic to penicillin.
Results The reported adverse drug reaction rate for amoxicillin AP was 0 fatal reactions/million prescriptions (in fact 0 fatal reactions for nearly 3 million prescriptions) and 22.62 non-fatal reactions/million prescriptions. For clindamycin, it was 13 fatal and 149 non-fatal reactions/million prescriptions. Most clindamycin adverse drug reactions were Clostridium difficile infections.
Conclusions AP adverse drug reaction reporting rates in England were low, particularly for amoxicillin, and lower than previous estimates. This suggests that amoxicillin AP is comparatively safe for patients without a history of amoxicillin allergy. The use of clindamycin AP was, however, associated with significant rates of fatal and non-fatal adverse drug reactions associated with C. difficile infections. These were higher than expected and similar to those for other doses, durations and routes of clindamycin administration.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2015 The Author/s. This is an author produced version of a paper subsequently published in Journal of Antimicrobial Chemotherapy. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | adverse drug reactions; amoxicillin; clindamycin; dental |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Clinical Dentistry (Sheffield) |
Funding Information: | Funder Grant number Heart Research UK RG2632/13/14 National Institutes for Health (NIH) - National Institute for Dental and Craniofacial Research (NIDCR) 1R03DE023092-01 National Institutes for Health (NIH) - National Institute for Dental and Craniofacial Research (NIDCR) 1R03DE023092-01 REVISED |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 08 May 2017 11:46 |
Last Modified: | 18 Jul 2017 10:07 |
Published Version: | https://doi.org/10.1093/jac/dkv115 |
Status: | Published |
Publisher: | Oxford University Press |
Refereed: | Yes |
Identification Number: | 10.1093/jac/dkv115 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:115892 |