Interventions to improve antibiotic use among dentists: a systematic review and meta-analysis

To analyse the effectiveness of various strategies, such as audits, education and digital tools, in reducing inappropriate antibiotic prescription by dentists. This study provides a comprehensive overview of how such interventions can contribute to improving clinical practice and combatting antimicrobial resistance in the dental setting.

An electronic search of articles published until 2023 in the following databases was performed: MEDLINE, SCOPUS, EMBASE, COCHRANE CENTRAL, LILACS and BBO. Systematic data synthesis and meta-analysis was carried out. A total of 23 studies regarding interventions to reduce antibiotic prescription among dentists were included. The studies were mostly published in the UK between 1997 and 2023. Of the 23 studies, three were trials and 20 were pre-post studies.

In general, interventions among dentists resulted in a 70% reduction in the inappropriate prescription of antibiotics (95% CI: 33.3% to 86.4%), which is an extremely high percentage. In the pre-post studies, the reduction was 71% (95% CI 28.8%-88.1%) I2 99.2%. In randomized controlled trial studies, a 63.9% (95% CI 41%-78.1%) I2 0% reduction was achieved. The greatest magnitude of effect was found in audit-based interventions with audit and education intervention at 73.3% (95% CI 44%-87.4%) and audit and feedback 75% (95% CI 33%-91.4%), respectively. However, the quality of the evidence is low, mostly due to the study design.

Given the magnitude of the effect found, it has been shown that dentists are receptive to improving their prescription of antibiotics. However, it is clear that there is ample room for improvement.