What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

Abstract

The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.

Dental Pain Medication Prescriptions in Minas Gerais, Brazil (2011–2021): A Time-Series Analysis

“…A higher number of dental procedures in certain regions suggests improved accessibility to curative dental care. While some cross-sectional studies have indicated a positive association between access to care and increased drug prescriptions [ 14 , 37 ], our time-series data analysis did not confirm this relationship with statistical significance. This suggests that additional individual-level factors, such as pain thresholds and clinical diagnoses, may play a central role in influencing dentists’ decisions to prescribe pain relievers [ 38 , 39 ].…”

Facts and trends in dental antibiotic and analgesic prescriptions in Germany, 2012–2021

“…The second-choice antibiotics included clindamycin (43.6%), the macrolides azithromycin and erythromycin (56.7%), cephalexin (18.4%), and amoxicillin/clavulanic acid combination (15.7%) [ 27 ]. In a current study from Brazil , the highest number of dental prescriptions was for amoxicillin, followed by macrolides like azithromycin [ 28 ]. Therefore, macrolides being antibiotics with solely bacteriostatic effects in contrast to the bactericidal penicillins, significantly impact Italy, Columbia, and Brazil more than Germany.…”

Antimicrobial resistance and virulence of subgingival staphylococci isolated from periodontal health and diseases

“…In fact, high rates of resistance or reduced susceptibility to penicillin (60%), amoxicillin (55%) and azithromycin (37%) were found among subgingival isolates from all clinical groups. These antimicrobials are routinely prescribed in dental practices, which could lead to reduced clinical efficacy 60 . In contrast, most isolates were susceptible to cefoxitin and amoxicillin-clavulanic acid.…”