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Paediatric antibiotic prescribing by general dental practitioners in England
N O Palmer1, M V Martin, R Pealing
1Department of Clinical Dental Sciences, University of Liverpool, UK.
Insights
General dental practitioners in England often prescribe liquid antibiotics for children inappropriately. This practice, including incorrect dosages and durations, may worsen antimicrobial resistance. Clearer guidelines and education are needed for these healthcare providers.
Area of Science:
- Pharmacology
- Public Health
- Pediatric Medicine
Background:
- Inappropriate antibiotic use is a significant driver of antimicrobial resistance.
- There is a lack of data on antibiotic prescribing patterns for pediatric patients by dental practitioners.
- This study addresses the gap by examining liquid antibiotic prescriptions for children in England.
Purpose of the Study:
- To investigate the prescribing patterns of liquid-based antibiotics for children by general dental practitioners (GDPs) in England.
- To identify variations in antibiotic choice, dosage, frequency, duration, and sugar content.
- To assess potential contributions to antimicrobial resistance.
Main Methods:
- Analysis of National Health Service (NHS) liquid-based prescriptions issued by GDPs in England.
- Inclusion of all prescriptions from 10 Health Authorities for February 1999.
- Detailed examination of pediatric liquid antibiotic prescriptions, including antibiotic type, sugar-free status, dose, frequency, and duration.
Main Results:
- Out of 18,614 antibiotic prescriptions, 1609 were liquid-based for children.
- Amoxicillin (75.5%) and phenoxymethylpenicillin (15.2%) were the most common antibiotics.
- Significant variations in dosage, frequency, and duration were observed, with many prescriptions deviating from manufacturer recommendations. Only 29.1% were sugar-free.
Conclusions:
- Some GDPs prescribe liquid antibiotics for children inappropriately.
- These prescribing practices may exacerbate the issue of antimicrobial resistance.
- Development of clear guidelines and educational programs for GDPs is recommended to improve prescribing habits.
Objectives:
The inappropriate use of antibiotics is known to be a major contributory factor to the problem of antimicrobial resistance. No information is available on how practitioners prescribe antibiotics for children. This study investigated the prescribing of liquid-based antibiotics for children by general dental practitioners in England.
Design:
Analysis of National Health Service liquid-based prescriptions issued by general dental practitioners in England.
Sample And Methods:
All prescriptions issued by practitioners in 10 Health Authorities in England for February 1999 were collected. All the liquid-based antibiotic prescriptions for children were selected and we investigated the type of antibiotic prescribed, whether sugar free, the dose, frequency and duration.
Results:
A total of 18,614 prescriptions were issued for antibiotics. Of the 1609 liquid-based paediatric prescriptions 88.3% were for generic and 11.7% for proprietary antibiotics, of which 75.5% were for amoxicillin, 15.2% for phenoxymethylpenicillin, 6.6% for erythromycin, 1.7% for metronidazole. Cephalexin, ampicillin, cephadrine and combinations of two antibiotics were also prescribed. There was a wide variation in dosages for all the antibiotics prescribed. A significant proportion of practitioners prescribed at frequencies inconsistent with manufacturers' recommendations and for prolonged periods, with some practitioners prescribing for periods up to 10 days. Only 29.1% of all the prescriptions issued were sugar free.
Conclusions:
The results of this study show that some practitioners prescribe liquid-based antibiotics inappropriately for children. This may contribute to the problem of antimicrobial resistance. Clear guidelines on the choice of antibiotic, dose, frequency and duration along with educational initiatives for GDPs might reverse this trend.