An audit of antimicrobial prescribing by dental practitioners in the north east of England and Cumbria

Sturrock, Andrew, Landes, D., Robson, T., Bird, L., Ojelabi, A. and Ling, J. (2018) An audit of antimicrobial prescribing by dental practitioners in the north east of England and Cumbria. BMC Oral Health, 18 (1). p. 206. ISSN 1472-6831

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Inappropriate prescribing of antimicrobials is a significant threat to global public health. In England, approximately 5% of all antimicrobial items are prescribed by dentists, despite the limited indications for their use in the treatment of oral infections in published clinical guidelines. The objective of this study was to survey antimicrobial prescribing by dental practitioners in North East England and Cumbria, identify educational and training needs and develop a self-assessment tool that can be used for Continued Professional Development by individual practitioners.

During October 2016, 275 dental practitioners used a standardised form to record anonymous information about patients who had been prescribed antimicrobials. Clinical information and prescribing details were compared against clinical guidelines published by the Faculty of General Dental Practitioners UK.

Dental practitioners provided data on 1893 antimicrobial prescriptions. There was documented evidence of systemic spread, such as pyrexia in 18% of patients. Dentists recorded patients’ pain (91.1% of patients), local lymph gland involvement (41.5%) gross diffuse swelling (55.5%) dysphagia (7.2%) and trismus (13.6%). Reasons for prescribing antimicrobials included patient expectations (25.8%), patient preference (24.8%), time pressures (10.9%), and patients uncooperative with other treatments (10.4%). The most commonly prescribed antimicrobials were amoxicillin, accounting for 61.2% of prescriptions, followed by metronidazole (29.9%). Most prescriptions for amoxicillin were for either 5 days (66.8%) or 7 days (29.6%) and most prescriptions for metronidazole were for a 5-day course (65.2%) or 7-day (18.6%) course.

In most cases, when an antimicrobial was prescribed, practitioners used the correct choice of agents and usually prescribed these at the correct dose. However, some evidence of suboptimal prescribing practices when compared to the Faculty of General Dental Practitioner guidelines were identified. The audit has identified training needs across the region and aided the development of Continued Professional Development sessions. Further work to identify barriers and facilitators for improving antimicrobial prescribing and determining appropriate methods to improve clinical practice are required.

Item Type: Article
Additional Information: Funding information: This research was funded by a grant from NHS England
Uncontrolled Keywords: Antibiotics, Audit, Dental, Prescribing
Subjects: A400 Clinical Dentistry
A900 Others in Medicine and Dentistry
Department: Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: Rachel Branson
Date Deposited: 15 Jun 2022 10:07
Last Modified: 15 Jun 2022 10:15

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