Antibiotic resistance and antibiotic prescribing by dentists in England 2007–2016

Abstract

The early prescribers of penicillin realised that antibiotics should be used wisely and as an adjunct to traditional surgical provision. They predicted that inappropriate use would increase sensitisation to the drug. National Health Service dentists prescribed almost 10% of antibiotics issued in NHS general practice in 2016 and an audit shows that many of these may have been prescribed inappropriately. One of the causes of antimicrobial resistance is over prescription of the drugs. This paper recalls the recommendations of some early users of penicillin, reports on the current prescription patterns of dentists in England, describes the mechanism of acquisition of anti-microbial resistance and discusses dentists' role in attempting to reduce the problem.

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

“…The highest prescription rate of antibiotics, among all dental prescriptions, is consistent with findings of other studies. [6][7][8] It is not an easy task to compare DDD/1,000 residents/year in our study and others. Firstly, because few studies evaluate DDD indicators to analyze dental prescriptions.…”

“…Antibiotics, along with painkillers, are the medications most commonly prescribed by dentists for the treatment of dental and oral complaints. 6,7 The prescription of antibiotics by dentists can be prophylactic or therapeutic and have increased over time. 8,9,10 The standards of drug prescription in dental practices have been frequently researched by means of professionals' self-report 11 without the objective evaluation of the actual prescriptions.…”

Trends in Antibiotic Self-Medication for Dental Pathologies among Patients in the Dominican Republic: A Cross-Sectional Study

“…These results are consistent with the trend observed in the United States, where the most prescribed medications are azithromycin, amoxicillin, amoxicillin/clavulanic acid, cephalexin (Access group), and ciprofloxacin (Watch group) [ 47 ]. Amoxicillin is the drug of choice for the treatment of many oral infections [ 13 , 48 , 49 , 50 ], and as patients tend to acquire previously prescribed antibiotics, it could explain the higher frequency of penicillin use in this study. These data are also consistent with a study conducted in Saudi Arabia on self-medication with antibiotics, with amoxicillin/clavulanic acid being the most commonly used drug, followed by amoxicillin and metronidazole (Access group) [ 44 ], as well as with a study conducted in Brazilian patients, where amoxicillin was also the most frequent antimicrobial [ 39 ].…”

An evaluation of sepsis in dentistry

“…59 In England, 5% of all antimicrobial prescribing is provided by dentists, and several studies have identified numerous factors including patient expectations, preferences and clinical and time pressures as reasons influencing prescribing behaviour. [60][61][62][63][64] Long and repeated durations of broad spectrum antimicrobials will apply a selective pressure favouring resistant microorganisms, hence careful consideration is required prior to prescription. 65 Preventive measures and rRemoval of the source of infection early is important to prevent severe odontogenic infections spreading and their complications including sepsis.…”