A study of prophylactic antibiotic prescribing in National Health Service general dental practice in England

Palmer, N.; Pealing, R.; Ireland, R.; Martin, M.

doi:10.1038/sj.bdj.4800597a

Cited by 25 publications

(11 citation statements)

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“…This confirmed the results of a questionnaire study carried out in general dental practice in England. 4,5 There was a significant reduction in the number of inappropriate reasons for prescribing during the audit with fewer practitioners prescribing due to uncertainty of diagnosis, pressure of time, patient expectation, pain and localised swelling. There was also a reduction in the number of prescriptions for periodontal and periapical abscesses, pulpitis, infected sockets, sinusitis and following minor oral surgery.…”

Section: Discussionmentioning

confidence: 99%

“…2 There is evidence that antibiotics are prescribed inappropriately in general dental practice. [3][4][5] With the increasing worldwide problem of antimicrobial resistance and the threat to public health, there is a need to rationalise the prescribing of antibiotics. 6 RESEARCH pharmacology practices between the pre-audit and audit periods were tested for significance using the chi-square test.…”

Section: Discussionmentioning

confidence: 99%

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Can audit improve antibiotic prescribing in general dental practice?

2001

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Can audit improve antibiotic prescribing in general dental practice?

2001

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“…1,2 Nevertheless, out of the 40 million oral antibiotics dispensed in the community in England each year, about 7% of them are prescribed by dentists. 3 Throughout the United Kingdom, many have been shown to be both inappropriate and suboptimal, [4][5][6][7] quite often given either as a substitute for operative intervention of a dental infection, 7 or as an adjunct, even in the absence of any signs of systemic involvement. 4 Such practice is not without its attendant consequences, which include life threatening anaphylactic reactions to penicillin with an estimated incidence of 0.04%, 8 and the development of potentially fatal orofacial infections.…”

Section: Introductionmentioning

confidence: 99%

The impact of clinical audit on antibiotic prescribing in general dental practice

Chate¹,

White

Hale

et al. 2006

Br Dent J

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• Describes an audit undertaken in the East of England on antibiotic prescribing in general dental practice.• The protocols of an original North West of England audit published in 2001 were deliberately replicated, in order to be able to pool the data and obtain a sample size of at least 1% of all UK dentists.• The combined Regional results confi rm that clinical audit reduces both the number of errors made by dental practitioners when writing out a prescription, as well as the number of those which are issued inappropriately, as compared to contemporary prescribing guidelines. I N B R I E FThe impact of clinical audit on antibiotic prescribing in general dental practice Objective To reduce the number of antibiotics inappropriately prescribed by general dental practitioners, and to increase overall prescription accuracy. Design A prospective clinical audit carried out between September and March of 2002-3 and 2003-4. Setting General dental practices in Eastern England. Subjects and methods The pre-audit antibiotic prescribing practices of 212 general dental practitioners were recorded over an initial six week period. On each occasion this included which antibiotic had been chosen, together with its dose, frequency and duration, as well as the clinical condition and reason for which the prescription had been raised. When related to prophylaxis, the patient's medical history was also noted. Following education on contemporary prescribing guidelines, presentations which illustrated the practitioners' previous errors, and the agreement of standards to be achieved, the process was repeated for another six weeks, and the results compared. Results In the pre-audit period, 2,951 antibiotic prescriptions were issued, and during the audit this was reduced by 43.6% to 1,665. The majority were for therapeutic reasons, with only 10.5% and 13.6% for medical prophylaxis during the pre-audit and audit periods respectively. Over both periods, amoxicillin and metronidazole were the two most commonly prescribed antimicrobials (63.4% and 21.2% respectively). In the pre-audit period, only 43% of all prescriptions were error free in dose, frequency, and/or duration of use, but this rose signifi cantly to 78% during the audit. Equally, using contemporary published guidelines, out of all the prescriptions made in the pre-audit period, only 29.2% were deemed to be justifi ed, as compared to 48.5% during the audit. Conclusions Clinical audit, in conjunction with education, and prescribing guidelines can favourably change antibiotic prescribing patterns among general dental practitioners.

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“…Evidence from further studies further suggests that antibiotics are being prescribed inappropriately within general dental practice. [6][7][8][9] However these studies are based upon hypothetical case scenario questionnaires. They are unable to predict the effect…”

Section: And M V Martinmentioning

confidence: 99%