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Antibiotic prescribing in UK general dental practice: a cross-sectional study

Antibiotic prescribing in UK general dental practice: a cross-sectional study
Antibiotic prescribing in UK general dental practice: a cross-sectional study
Objectives

To assess the extent to which antibiotic prescribing in general dental practice conforms to clinical guidelines and to describe factors associated with antibiotic prescription in the absence of spreading infection or systemic involvement.

Methods

A cross‐sectional study of the management of adult patients with acute dental conditions by General Dental Practitioners (GDPs) in Wales, UK. Clinical information on the management of patients was compared to clinical and prescribing guidelines published by the Scottish Dental Clinical Effectiveness Programme and the Faculty of General Dental Practice (UK). Multilevel logistic regression was used to identify patient, practitioner and consultation characteristics predictive of antibiotic prescribing in the absence of infection.

Results

Antibiotics were prescribed to 57.4% of 568 patients. Over half of antibiotics (65.6%) were prescribed in situations where there was no evidence of spreading infection, and 70.6% were used without the provision of an operative intervention. Only 19.0% of antibiotics were prescribed in situations where their use was indicated by clinical guidelines. Factors associated (P < 0.05) with antibiotic prescription in the absence of infection were failure of previous operative treatment (Odds Ratio (OR) 13.57), shortage of clinical time to undertake treatment (OR 10.21), patients who were unable or unwilling to accept operative treatment (OR 4.89), patient requests for antibiotics (OR 3.69) and acute periodontal conditions (OR 3.37).

Conclusions

A high level of inappropriate antibiotic prescribing was observed amongst the GDPs studied. Features of the healthcare environment, such as clinical time pressures, and patient‐related characteristics, such as expectations for antibiotics and refusal of operative treatment, are associated with antibiotic prescribing in the absence of infection. Individuals responsible for the commissioning and delivery of dental services should seek to develop targeted interventions addressing these issues in order to ensure optimal antimicrobial stewardship within dentistry.

antimicrobial resistance, general dental practice, guideline adherence, health services research, pharmacology
145-153
Cope, Anwen
a81ac79a-434d-4a43-bfb1-f2baf5d8c9ca
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Wood, Fiona Claire
7fa2fcc6-81ab-4acf-997e-4c7113c7b1fd
Chestnutt, Ivor Gordon
9e5aa7b4-0d23-443d-bb53-08dd5703ba37
Cope, Anwen
a81ac79a-434d-4a43-bfb1-f2baf5d8c9ca
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Wood, Fiona Claire
7fa2fcc6-81ab-4acf-997e-4c7113c7b1fd
Chestnutt, Ivor Gordon
9e5aa7b4-0d23-443d-bb53-08dd5703ba37

Cope, Anwen, Francis, Nicholas Andrew, Wood, Fiona Claire and Chestnutt, Ivor Gordon (2016) Antibiotic prescribing in UK general dental practice: a cross-sectional study. Community Dentistry and Oral Epidemiology, 44 (2), 145-153. (doi:10.1111/cdoe.12199).

Record type: Article

Abstract

Objectives

To assess the extent to which antibiotic prescribing in general dental practice conforms to clinical guidelines and to describe factors associated with antibiotic prescription in the absence of spreading infection or systemic involvement.

Methods

A cross‐sectional study of the management of adult patients with acute dental conditions by General Dental Practitioners (GDPs) in Wales, UK. Clinical information on the management of patients was compared to clinical and prescribing guidelines published by the Scottish Dental Clinical Effectiveness Programme and the Faculty of General Dental Practice (UK). Multilevel logistic regression was used to identify patient, practitioner and consultation characteristics predictive of antibiotic prescribing in the absence of infection.

Results

Antibiotics were prescribed to 57.4% of 568 patients. Over half of antibiotics (65.6%) were prescribed in situations where there was no evidence of spreading infection, and 70.6% were used without the provision of an operative intervention. Only 19.0% of antibiotics were prescribed in situations where their use was indicated by clinical guidelines. Factors associated (P < 0.05) with antibiotic prescription in the absence of infection were failure of previous operative treatment (Odds Ratio (OR) 13.57), shortage of clinical time to undertake treatment (OR 10.21), patients who were unable or unwilling to accept operative treatment (OR 4.89), patient requests for antibiotics (OR 3.69) and acute periodontal conditions (OR 3.37).

Conclusions

A high level of inappropriate antibiotic prescribing was observed amongst the GDPs studied. Features of the healthcare environment, such as clinical time pressures, and patient‐related characteristics, such as expectations for antibiotics and refusal of operative treatment, are associated with antibiotic prescribing in the absence of infection. Individuals responsible for the commissioning and delivery of dental services should seek to develop targeted interventions addressing these issues in order to ensure optimal antimicrobial stewardship within dentistry.

Full text not available from this repository.

More information

e-pub ahead of print date: 27 October 2015
Published date: 3 March 2016
Keywords: antimicrobial resistance, general dental practice, guideline adherence, health services research, pharmacology

Identifiers

Local EPrints ID: 436082
URI: http://eprints.soton.ac.uk/id/eprint/436082
PURE UUID: f23e303a-0dfa-4c8d-9681-6609212ecb98
ORCID for Nicholas Andrew Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 27 Nov 2019 17:30
Last modified: 17 Dec 2019 01:20

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