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Trends in Antibiotic Prescriptions by Oral and Maxillofacial Surgeons to Medicare Beneficiaries, 2013-2022
Lang Liang1, Tim T Wang2, Cameron C Lee3
1DMD Candidate, Harvard School of Dental Medicine, Boston, MA.
Background:
Oral and maxillofacial surgeons frequently prescribe antibiotics, yet their prescribing patterns are not well studied on a national level.
Purpose:
The purpose of this study was to quantify and characterize antibiotic prescriptions to Medicare beneficiaries by oral and maxillofacial surgeons in 2013-2022.
Study Design, Setting, And Sample:
This retrospective cohort study used the Medicare Part D Prescribers data sets, 2013-2022. Providers with a specialty description of oral and maxillofacial surgery (OMS) and had antibiotic prescription data available were included.
Predictor Variable:
The primary predictor variable was the year of prescription (2013-2022).
Outcome Variable:
The primary outcome variable was the number of antibiotic claims per 1,000 beneficiaries. Secondary outcome variables included total antibiotic claims and claims per provider.
Covariates:
Covariates included provider sex and region of practice.
Analyses:
Descriptive statistics were calculated. Linear regression was utilized to assess changes in outcome variables in 2013-2022. The top 10% of antibiotic prescribers were categorized based on total antibiotic claims. Bivariate analyses were used to evaluate which characteristics were associated with the top 10% of prescribers.
Results:
The number of surgeons each year in 2013-2022 ranged from 6,070 to 6,538. The total number of antibiotic claims in 2013-2022 was 6,803,957. The total number of antibiotic claims in 2013 and 2022 were 475,201 and 931,803, respectively. The mean claims per 1,000 beneficiaries and claims per surgeon in 2013-2022 were 874.6 and 106.9, respectively. The mean claims per 1,000 beneficiaries were 806.4 in 2013 and 946.2 in 2022, with an estimated yearly increase of 16.1 (P < .001). The mean claims per surgeon significantly increased from 2013 (78.3) to 2022 (144.9) by approximately 6.5 each year (P < .001). Amoxicillin was the most prescribed antibiotic, with the claims per 1,000 beneficiaries also increasing from 2013 (511.8) to 2022 (662.7) by approximately 17.1 each year (P < .001). The top 10% of antibiotic prescribers accounted for 29.5 to 31.0% of the total antibiotic volume depending on the year.
Conclusions And Relevance:
These findings suggest that antibiotic prescribing is increasing among oral and maxillofacial surgeons. Antibiotic stewardship interventions, especially tailored toward high-volume prescribers, may be beneficial in reducing overall antibiotic prescription volume.
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