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Medicine Pharmacology Professional Issues Supporting Your Practice

Conversation Opener: Antibiotics prescribing patterns among health professionals in B.C.

David-PatrickDr. David Patrick spoke with Dr. John O’Keefe about the prescribing patterns of antibiotics among health professionals in B.C.

Dr. David Patrick is a medical doctor, Associate professor in the Division of infectious diseases, School of Population and Public Health at UBC, and Director of Epidemiology Services at the BC Center for Disease Control.

To contact Dr. David Patrick by email: david.patrick@ubc.ca 

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  1. Robert Murray March 9, 2015

    Likely more use of antibiotics is made by general dentists who want to stay within their comfort zone and temporize their surgical or endodontic patients while they wait for an appointment with the specialist to begin treatment. This could take a few weeks and is not a good use of antibiotics. A lot of these patients arrive at the endodontist’s office on antibiotics without active infection and perhaps a hopeless split tooth that required an extraction in the first place. This is hard on the referring dentist who may have difficulty breaking the bad news and prefer to have someone else do it. A whole day of continuing education on the “split” tooth and this type of situation is needed.

  2. Reza Nouri March 10, 2015

    Another concern is the prophylactic use of antibiotics following surgical treatment, e.g. endodontic, oral surgery, and implant placement, in order to reduce the risk of post-operative complications. It may be wise to run a comparative study to see if the 62% increase in antibiotic use between 1996 to 2013 correlates with that of dental implants.

  3. Anon March 10, 2015

    Many dental patients expect antibiotics for acute periapical abscesses. When most dentists in the neighborhood are giving antibiotics, there is a serious business and reputation risk of not following the trend.

    1. In fact, in my experience, patients tend to appreciate the issue of antibiotic resistance, both on a global and personal level, when I explain the rationale behind not prescribing antibiotics for certain diagnoses that I have rendered.

      Certainly, there are conditions that call for antibiotics, when other means are not available to us to reduce the bacterial load in a timely manner, or when the extent and severity of the infection is significant.

      I agree with Dr. Nouri, that there may have been a confounding factor that the number of surgical / implant procedures that dentists have been performing have increased during the term of the study. However, 62% surprised me somewhat.

      A rebuttal to ANON: If I am prescribing because I worry about my business risk of not following the trend, then I have forgotten to be a professional. If I am prescribing because I worry about my reputation, then I have misunderstood that the reputation of being a good dentist comes from 1) being truthful/professional, 2) educating the patient, and 3) rendering a favourable clinical outcome through appropriate treatment. What if the antibiotics I typically over-prescribe finally stops working?

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