Shift in antibiotic prescription at a University Dental Clinic in Norway 2013-2017

A considerable number of prescriptions for antibiotics are issued by dentists. Educational institutions have a special responsibility to promote informed attitudes among dental students towards prescribing antibiotics. The purpose of this study was to analyze the antibiotic prescriptions issued during a 5-year period (2013-2017) at a University Dental Clinic (UDC) in Norway. All patient records containing prescriptions for patients ≥18 yr of age as of 2013-2017 were identified through an electronic search. In total, 6,014 patient record lines containing prescriptions were obtained, 1,047 (17.4%) of which were prescriptions for systemic antibiotics. These patient record lines were analysed to identify the specific antibiotic prescribed, the indication or diagnosis for which it was prescribed, and whether microbiological testing (to determine antibiotic sensitivity) had been carried out. Acute infections were the most common context for prescribing antibiotics. Surprisingly, prophylaxis was the second most frequent reason stated. Disease related to pulp necrosis (43%) and postoperative infections (26%) was the most common diagnosis for therapeutic antibiotic prescriptions. Antibiotic therapy was more commonly used to treat peri-implantitis than to treat periodontitis. Only 60% of the clindamycin prescriptions were issued to patients with penicillin allergy. Further studies are warranted concerning antibiotic use at UDC because this can probably be more restrictive, in particular concerning usage related to antibiotic prophylaxis. Microbiological testing should be performed before administration of antibiotic therapy for periodontitis and peri-implantitis. The reason for prescribing antibiotics should always be stated in the patient's record lines.