ArticleInfection2026
Increasing contribution of dental antibiotic prescribing to community-acquired Clostridioides difficile infection: a 9-year retrospective cohort study.
Article in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors.
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Abstract
purposeCommunity-acquired Clostridioides difficile infection (CA-CDI) is increasingly recognized outside healthcare settings, yet the contribution of dental antibiotic prescribing remains poorly characterized. This study compared patients with CA-CDI following antibiotics prescribed by dental practitioners versus family physicians.
methodsWe conducted a retrospective cohort study at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia, including adults with a first episode of confirmed CA-CDI following outpatient antibiotic exposure between 2011 and 2019. Characteristics were compared by prescriber.
resultsAmong 666 patients with CA-CDI, 190 (28.5%) had received antibiotics from dental practitioners and 476 (71.5%) from family physicians. Dental-associated CA-CDI increased significantly over time (13.1% in 2011 to 31.1% in 2019; p = 0.003). Dental patients had a lower comorbidity burden, with less frequent diabetes, chronic obstructive pulmonary disease, and proton pump inhibitor use. Amoxicillin-clavulanate was the most frequently prescribed antibiotic overall; clindamycin was more common among dental patients (39.9% vs. 11.9%), 79.7% of whom had no penicillin allergy. Severity and treatment duration were similar between groups.
conclusionDental antibiotic prescribing emerged as an increasingly important contributor to CA-CDI, associated with higher clindamycin use despite a lower burden of traditional risk factors, highlighting the need to strengthen antimicrobial stewardship in dental practice.
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