背景：在牙科手术前作为感染预防处方的抗生素有可能导致严重的药物不良事件（ADE）。然而,指南一致性和不同牙科设置与抗生素预防产生的ADE相关的程度尚不清楚.目的：目的是评估指南一致性和抗生素相关的ADE，以及它是否因VA和非VA设置而不同。方法：回顾性队列研究，从2015年至2017年，对患有心脏病或人工关节的成年人进行抗生素预防。多变量逻辑回归模型适合评估ADE的影响，指南一致性和牙科设置。一致性与牙齿设置的相互作用项评估了ADE与一致性之间的关系是否因设置而异。结果：从2015年到2017年，61,124例接受抗生素预防的患者被确定为62例（0.1％）患有ADE。在那些具有指导方针一致性的人中，18例（0.09%）有ADE，而44例（0.1%）使用不一致抗生素的患者有ADE（未调整OR：0.84，95%CI：0.49-1.45）。调整后的分析表明，指南一致性与ADE无关（OR：0.78，95％CI：0.25-2.46），这种关系因牙齿设置而没有差异(相互作用的Waldχ^2p值=0.601)。结论：抗生素相关的ADE在设置或指南一致性方面没有差异。
Background: Antibiotics prescribed as infection prophylaxis prior to dental procedures have the potential for serious adverse drug events (ADEs). However, the extent to which
guideline concordance and different dental settings are associated with ADEs from antibiotic prophylaxis is unknown. Aim: The purpose was to assess
guideline concordance and antibiotic-associated ADEs and whether it differs by VA and non-VA settings. Methods: Retrospective cohort study of antibiotic prophylaxis prescribed to adults with cardiac conditions or prosthetic joints from 2015 to 2017. Multivariable logistic regression models were fit to assess the impact of ADEs,
guideline concordance and dental setting. An interaction term of concordance and dental setting evaluated whether the relationship between ADEs and concordance differed by setting. Results: From 2015 to 2017, 61,124 patients with antibiotic prophylaxis were identified with 62 (0.1%) having an ADE. Of those with
guideline concordance, 18 (0.09%) had an ADE while 44 (0.1%) of those with a discordant antibiotic had an ADE (unadjusted OR: 0.84, 95% CI: 0.49-1.45). Adjusted analyses showed that guideline concordance was not associated with ADEs (OR: 0.78, 95% CI: 0.25-2.46), and this relationship did not differ by dental setting (Wald χ^2 p-value for interaction = 0.601). Conclusion: Antibiotic-associated ADEs did not differ by setting or
guideline concordance.
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