Dental Antibiotic Prescribing Practices and Antimicrobial Resistance Knowledge in Singapore

While dental antibiotic prescribing accounts for approximately 10% of all antibiotic prescriptions across human healthcare worldwide, up to 80% are inappropriate. These contribute to the growing global health threat of antimicrobial resistance (AMR). Effective antibiotic stewardship requires an up-to-date understanding of antibiotic prescribing practices and knowledge. This study aimed to assess the antibiotic prescribing practices, knowledge and attitudes among dentists in Singapore.

A survey was distributed in 2024 to dentists using convenience sampling through the mailing lists of professional dental organisations. Appropriate use was assessed by comparing the responses with dental prescribing guidelines and stratified by clinical specialty. Multivariable logistic regressions were used to identify dentist characteristics predicting appropriate prescribing.

Two hundred and eighty dentists completed the questionnaire. Appropriate antibiotic prescribing varied widely, ranging from 6.5% to 97.7% across clinical scenarios. The lowest appropriate prescribing rates were observed for periodontal scenarios (30.4% ± 37.5%). Rates were similarly low for oral surgery scenarios (34.0% ± 29.0%) but higher for restorative (58.3% ± 28.6%) and for the management of medically complex patients (56.6% ± 18.0%). When faced with nonclinical pressures (eg, patient request for antibiotics, lack of a definitive diagnosis), only 21.1% to 37.5% practised appropriate prescribing. In multivariable regressions, locally trained dentists, those in the public sector, and those with fewer years of experience showed higher rates of appropriate prescribing.

Although dentists recognised the importance of appropriate antibiotic use and the threat of AMR, many demonstrated inappropriate prescribing and gaps in their understanding of AMR. Future training interventions could increase awareness of recently published local guidelines and offer digital resources to address knowledge gaps and meet training demand. Implementation strategies are also needed to translate interventions into practice.

Understanding antibiotic prescribing practices, knowledge, and attitudes among dentists in Singapore can guide targeted interventions to enhance antibiotic stewardship within the dental profession.