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Why has antibiotic prescribing by dentists increased? A Canadian Study

This is a summary of an article that has just been published by the Journal of the American Dental Association on trends of antibiotics prescription in British Columbia, Canada. At a time, when antibiotics use should be declining due to increased antibacterial resistance, dentists are prescribing antibiotics at a higher rate. 

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Background

Although the overall rate of antibiotic prescribing has been declining in British Columbia, Canada, the authors conducted a study to explain the increased rate of prescribing by dentists.

Discussion

  • The absolute increase in dental prescribing [of antibiotics] was sufficient to substantially blunt the expected decline in antibiotic use at a population level associated with observed changes in physician practice.
  • The prescribing of the narrow spectrum agent, penicillin V, has decreased significantly, whereas the use of amoxicillin and combinations of amoxicillin and enzyme inhibitors has increased. This is of concern because penicillin V continues to be recommended as a first-line agent for many dental indications and it retains suitable coverage across much of the oral flora.
  • The increase in antibiotic prescribing by dentists that we observed in our study is of concern as it is occurring at a time when the use of recommendations and guidelines should be producing a decrease.
  • Another identified reason for overprescribing is the slow or incomplete adoption of new guidelines calling for a descreased use of perioperative antibiotics in patients with valvular heart disease and prosthetic joints.

Practical Implications

  • Antibiotic prescribing should be reviewed to make sure that we are compliant with guidelines. Most practitioners will find opportunities to prescribe less often and for shorter durations.

Related Oasis Discussions Post: Conversation Opener: Antibiotics prescribing patterns among health professionals in B.C.

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