Characteristics of dentists and patients associated with appropriate antibiotic prescriptions by French dentists: a cross-sectional study using Health Insurance databases

Abstract

Background – The use of antibiotics in dental care is often unnecessary or inappropriate. Our objectives were to identify (i) clusters of dentists grouped according to their appropriateness score based on proxy indicators’ results; and (ii) dentists’ and patients’ characteristics associated with the appropriateness of antibiotic prescriptions.Methods – We used data of the Health Insurance reimbursement databases on antibiotics prescribed in 2019 by general dental practitioners of the Grand Est region in France. The appropriateness of antibiotic prescriptions was estimated by the results of recently published proxy indicators. We conducted a cluster analysis according to an appropriateness score calculated for each dentist, using the Ward method. We then conducted bivariate and multivariable analyses to identify characteristics associated with these clusters.Results – We included 3,014 dentists, which were grouped into three clusters. We identified several characteristics significantly associated with the appropriateness of antibiotic prescriptions. Overall, dentists had more appropriate prescription practices when they were male, having a predominant surgery practice in the Lorraine area for less years, when they had healthier patients (i.e. younger, with no chronic diseases, and who received less procedures), and when they had a more prudent use of drugs in general (i.e. less drug expenses, less prescriptions of all drugs, less prescriptions of antibiotics and less prescriptions of systemic non-steroidal anti-inflammatory drugs).Conclusions – We identified clusters and characteristics associated with the appropriateness of antibiotic prescriptions made by dentists, which might help guiding antimicrobial stewardship interventions.