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Antibiotic prescribing by dentists has increased: Why?

Fawziah Marra, Diana George, Mei Chong

    Journal of the American Dental Association (1939)
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    Dentist antibiotic prescribing increased significantly from 1996-2013, despite an overall decline in antibiotic use. Key drivers include unnecessary prescriptions, dental implants, and cosmetic procedures, highlighting a need for antibiotic stewardship in dental education.

    Keywords:
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    Area of Science:

    • Dental Public Health
    • Infectious Disease Epidemiology
    • Pharmacology

    Background:

    • Overall antibiotic prescribing in British Columbia has declined.
    • A study was conducted to investigate the rise in antibiotic prescriptions issued by dentists.

    Purpose of the Study:

    • To explain the increasing trend of antibiotic prescribing by dentists in British Columbia.
    • To identify the key factors contributing to the rise in dental antibiotic prescriptions.

    Main Methods:

    • Anonymized outpatient prescription data from 1996 to 2013 were analyzed.
    • Prescribing rates were normalized to population and expressed as Defined Daily Doses (DDD) per 1,000 inhabitants per day (DID).
    • Correspondence from dentists was collected to understand prescribing drivers.

    Main Results:

    • Overall antibiotic use and physician prescribing declined between 1996 and 2013.
    • Dental prescribing increased by 62.2%, rising from 0.98 to 1.59 DID, and its proportion of total antibiotic prescriptions grew from 6.7% to 11.3%.
    • Factors identified include unnecessary prescriptions, dental implants, slow guideline adoption, cosmetic procedures, underinsurance, an aging population, and increased dentist numbers.

    Conclusions:

    • Identified themes in dental prescribing warrant further investigation.
    • These themes can inform antibiotic stewardship priorities for dental continuing education.