Objective To describe the findings of the first cycle of a clinical audit of antimicrobial use by general dental practitioners (GDPs).Setting General dental practices in Wales, UK.Subjects and methods Between April 2012 and March 2015, 279 GDPs completed the audit. Anonymous information about patients prescribed antimicrobials was recorded. Clinical information about the presentation and management of patients was compared to clinical guidelines published by the Scottish Dental Clinical Effectiveness Programme (SDCEP).Results During the data collection period, 5,782 antimicrobials were prescribed in clinical encounters with 5,460 patients. Of these 95.3% were antibiotic preparations, 2.7% were antifungal agents, and 0.6% were antivirals. Of all patients prescribed antibiotics, only 37.2% had signs of spreading infection or systemic involvement recorded, and 31.2% received no dental treatment. In total, 79.2% of antibiotic, 69.4% of antifungal, and 57.6% of antiviral preparations met audit standards for dose, frequency, and duration. GDPs identified that failure of previous local measures, patient unwillingness or inability to receive treatment, patient demand, time pressures, and patients' medical history may influence their prescribing behaviours.Conclusions The findings of the audit indicate a need for interventions to support GDPs so that they may make sustainable improvements to their antimicrobial prescribing practices.

Principals and trainees in general practice attending training events were asked to give information about their prescribing of drugs, with a focus on the prescribing of benzodiazepines for psychological problems. High prescribers of benzodiazepines believed that a prescription saved consultation time, tended to be influenced by drug company information and believed that patients expected a prescription. Low prescribers of benzodiazepines did not prescribe for bereavement, wished to have more psychological expertise and offered treatments other than drugs. Doctors classified as empathic from their statements at interview found difficulty in ending consultations and thought that social problems should be part of the general practitioner's work, although there were no differences between empathic and unsympathetic doctors in overall prescribing rates of benzodiazepines. The data suggest that doctors who are emphatic towards their patients would prescribe less if they had training in psychological skills.

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