Antibiotic prescribing in <scp>UK</scp> general dental practice: a cross‐sectional study

Cope, Anwen; Francis, Nick; Wood, Fiona; Chestnutt, Ivor Gordon

doi:10.1111/cdoe.12199

Cited by 136 publications

(136 citation statements)

References 25 publications

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“…13, 20 For example, in a 2016 cross-sectional study analyzing antibiotic prescribing of 568 patients among general dentists, less than 20% of antibiotics were prescribed in situations consistent with clinical guidelines. 21 However, these issues are not limited to just the US and UK, inappropriate antibiotic prescribing practices among dentists is a worldwide problem. 22–24 …”

Section: Discussionmentioning

confidence: 99%

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An evaluation of dental antibiotic prescribing practices in the United States

Durkin¹,

Hsueh²,

Sallah³

et al. 2017

The Journal of the American Dental Association

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Background Antibiotic prescribing practices among dentists and dental specialists in the United States (US) remains poorly understood. The purpose of our study is to compare prescribing practices between dental specialties, evaluate the duration of antibiotics prescribed by dentists, and determine variation in antibiotic selection among dentists. Methods We performed a retrospective cross-sectional analysis of dental provider specialties linked to de-identified antibiotic claims data from a large pharmacy benefits manager during the 2015 calendar year. Results As a group, general dentists and dental specialists were responsible for over 2.7 million antibiotic prescriptions, higher than several other medical and allied health provider specialties. Antibiotic treatment duration was generally prolonged and commonly included broad-spectrum agents, such as amoxicillin-clavulanate and clindamycin. Although amoxicillin was the most commonly prescribed antibiotic among all dental specialties, there was significant variation among other antibiotics selected by each specialty. The most common antibiotic treatment durations were for 7 and 10 days. Conclusions This study demonstrates that dentists frequently prescribe antibiotics for prolonged periods of time and often use broad-spectrum antibiotics. Further studies are necessary to evaluate the appropriateness of these antibiotic prescribing patterns. Practical Implications The significant variation in antibiotic selection and treatment duration identified among all dental specialties in this study population implies that further research and guidance into the treatment of dental infections is necessary to improve and standardize antibiotic prescribing practices.

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Section: Discussionmentioning

confidence: 99%

“…16, 25 Other important factors include failure of previous operative treatment, shortage of clinical time, and patient pressure. 21, 26 …”

Section: Discussionmentioning

confidence: 99%

An evaluation of dental antibiotic prescribing practices in the United States

Durkin¹,

Hsueh²,

Sallah³

et al. 2017

The Journal of the American Dental Association

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“…As it has been previously reported that patients prefer antibiotic treatment and are often unwilling to accept operative intervention [34], the rapid symptomatic improvement of ADI with parenteral therapy may bolster these preferences and influence convalescent healthcare choices. Our finding that over a third of study participants reported recurrent infections might be a reflection of this.…”

Section: Discussionmentioning

confidence: 99%

Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

et al. 2017

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BackgroundThe number of Acute Dental Infections (ADI) presenting for emergency department (ED) care are steadily increasing. Outpatient Parenteral Antibiotic Therapy (OPAT) programs are increasingly utilized as an alternative cost-effective approach to the management of serious infectious diseases but their role in the management of severe ADI is not established. This study aims to address this knowledge gap through evaluation of ADI referrals to a regional OPAT program in a large Canadian center.MethodsAll adult ED and OPAT program ADI referrals from four acute care adult hospitals in Calgary, Alberta, were quantified using ICD diagnosis codes in a regional reporting system. Citywide OPAT program referrals were prospectively enrolled over a five-month period from February to June 2014. Participants completed a questionnaire and OPAT medical records were reviewed upon completion of care.ResultsOf 704 adults presenting to acute care facilities with dental infections during the study period 343 (49%) were referred to OPAT for ADI treatment and 110 were included in the study. Participant mean age was 44 years, 55% were women, and a majority of participants had dental insurance (65%), had seen a dentist in the past six months (65%) and reported prior dental infections (77%), 36% reporting the current ADI as a recurrence. Median length of parenteral antibiotic therapy was 3 days, average total course of antibiotics was 15-days, with a cumulative 1326 antibiotic days over the study period. There was no difference in total duration of antibiotics between broad and narrow spectrum regimes. Conservative cost estimate of OPAT care was $120,096, a cost savings of $597,434 (83%) compared with hospitalization.ConclusionsADI represent a common preventable cause of recurrent morbidity. Although OPAT programs may offer short-term cost savings compared with hospitalization, risks associated with extended antibiotic exposures and delayed definitive dental management must also be gauged.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2303-2) contains supplementary material, which is available to authorized users.

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“…However, it has been shown that the majority of these prescriptions are inappropriate (Cope et al . ).…”

Section: Introductionmentioning

confidence: 97%

Antibiotic prescribing for endodontic therapies: a comparative survey between general dental practitioners and final year Bachelor of Dental Surgery students in Cardiff, UK

et al. 2018

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Final year undergraduate students were aware of the antibiotic resistance crisis, although a third was not aware of guidelines for use of antibiotics in endodontic conditions; their responses to clinical scenario were generally compatible with the guidelines. General dentists were less aware of the implications of overuse of antibiotics and the existence of guidelines, and their responses were occasionally incompatible with antibiotic guidelines for endodontic therapies.

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Antibiotic prescribing in UK general dental practice: a cross‐sectional study

Cited by 136 publications

References 25 publications

An evaluation of dental antibiotic prescribing practices in the United States

An evaluation of dental antibiotic prescribing practices in the United States

Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

Antibiotic prescribing for endodontic therapies: a comparative survey between general dental practitioners and final year Bachelor of Dental Surgery students in Cardiff, UK

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