Stewardship of Antibiotics Prescribing in Belgian Dental Practice: A National Survey

This national survey examined factors influencing dentists' prudent antibiotic prescribing, barriers to implementing evidence-based guidelines in dental practice, and solutions to promote prudent prescribing. A validated online survey assessed dentists across five domains: participant characteristics, antibiotic prescribing practices, knowledge of antimicrobial resistance, barriers and solutions for prudent antibiotic use, and knowledge and adherence to evidence-based guidelines. A total of 811 dentists completed the survey (55.2% female). Antibiotic prescribing was mainly influenced by patients' clinical signs and symptoms (79.0%), immune status (73.0%), and medical/dental history (66.0%). Key contributors to antimicrobial resistance were frequent antibiotic prescribing (97.1%), patient self-medication with leftover antibiotics (95.1%), and use of broad-spectrum agents when narrower options were available (90.3%). Only 25% of participants were familiar with evidence-based guidelines. Regression analysis showed region and professional experience as significantly associated with compliance with prophylactic/therapeutic antibiotic prescribing to protect patients (OR = 1.7-1.5; p < 0.025). Awareness of the evidence-based guidelines, working ≤ 30 h/week, and receiving prescription feedback were significantly associated with compliance with therapeutic antibiotic prescribing to protect society (OR = 1.8-1.5; p < 0.030). Information technology support was perceived as a useful aid for prescribing. Antibiotics are still prescribed for inappropriate indications. Continued efforts are needed to raise awareness and strengthen antibiotic stewardship in daily practice.