Dentaltown December 2017 - 44

message board
davidpalmer
Member Since: 04/14/00
Post: 53 of 88

I can understand how any doctor who prescribes an antibiotic to someone who is allergic to
it is likely to be in trouble. Did the patient tell the doctor he was not allergic to amoxicillin? Did
the doctor ask if the patient was allergic to amoxicillin? Fill us in on some details. ■
9/5/2017

silverback123
Member Since: 05/28/15
Post: 59 of 88

I would think you would win an appeal if the health hx form asks about allergies and the
patient says "no" or "none." Couldn't you argue a surgical ext with a flap, etc., introduced a lot
of bacteria from the mouth and instruments into the site, and antibiotics were prescribed to
prevent infection? The details of these cases could change our perception of why the dentists
lost. Overprescribing antibiotics is a horrible problem but if the powers that be cared about
antibiotic resistance, they would better protect providers from these lawsuits. ■
9/5/2017

stayinschool
Member Since: 02/08/15
Post: 62 of 88

I think we are dealing with short-term and long-term problems here, just like with so many
other things in life.
Short term: No one wants to take any chances and get sued, which is obviously reasonable.
(Survival is a prime instinct.)
Long term: The system does not protect dentists who practice evidence-based dentistry in a
litigious world. (As mentioned before, a jury is not going to understand if we try to explain the
evidence scientifically.)
Someone in organized medicine needs to help us out. ■
9/5/2017

justaDentist
Member Since: 10/14/12
Post: 63 of 88

Maybe a job for the ADA? Work with the other medical professions who prescribe antibiotics and publish a unified, definitive indication list for administration of antibiotic therapy to
minimize future resistance. I know this already exists academically, but this is more for legal/
court of public opinion purposes. ■
9/6/2017

wizexo
Member Since: 07/19/05
Post: 64 of 88

The point is not whether the allergy is/was known, or not. Reported or not. The case hinged
on the fact that the dentist gave a prescription for a medication that caused the reaction, while
there was no documented indication for the medication. ■
9/6/2017

davidpalmer
Member Since: 04/14/00
Post: 65 of 88

Remind me to put "Patient has a noted infection around tooth #" every single time I extract
a tooth and give postop ABX. I'm not a fan of CYA antibiotics, but if it hits the fan and you
didn't give them, it's an easy case for any attorney. Juries are sympathetic to the grieving family
and will never be convinced of the wisdom of the ADA guidelines while looking at a crying
widow. There's no good answer here. ■
9/6/2017

alanrw
Member Since: 05/16/11
Post: 69 of 88

pranavp
Member Since: 06/18/04
Post: 72 of 88

If there is no good answer here, as doctors shouldn't we follow the science, or do we just
become stupid like the juries? ■
9/6/2017

I was loving the science and explanations of this post initially. Then it evolved into a scary
reality of what can be. Bottom line is, we are screwed no matter how you do it. Prescribe away
and help the pt develop immunity to PCN, so the next infection that knocks a pt down becomes
your fault. Don't prescribe enough and you've given any ambulance chaser enough ammo to

DECEMBER 2017 // dentaltown.com

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