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

Abstract

The results obtained from this questionnaire support the conclusion that the therapeutic prescribing of antibiotics in general dental practice varies widely and is suboptimal. There is a clear need for the development of prescribing guidelines and educational initiatives to encourage the rational and appropriate use of the antibiotics in National Health Service general dental practice.

A retrospective investigation of the clinical management of patients attending an out of hours dental clinic in Merseyside under the new NHS dental contract

“…A number of studies in general dental practice have suggested that a lack of time and uncertainties about correct diagnosis were the main reasons for antibiotic prescribing. 27,28 The treatment modalities delivered in the OOH service by dentists and the overuse and inappropriate use of antibiotics also requires further research.…”

The role of phenoxymethylpenicillin, amoxicillin, metronidazole and clindamycin in the management of acute dentoalveolar abscesses – a review

“…4 Studies in the United Kingdom have consistently shown that there is widespread variation in the prescribing habits of GDPs, with many prescribing inappropriately, with inconsistent dose and frequency and often for prolonged periods. [4][5][6][7][8][9][10] This was also shown to be the case when patients sought advice and treatment from their general medical practitioners. 11 In a UK dental survey carried out by a major pharmaceutical company 12 looking at the factors infl uencing frequency and type of regularly prescribed antibiotic, 75% of dentists gave antibiotics at least once a week with over 15% of those dentists prescribing them on a daily basis.…”

“…[4][5][6][7][8][9][10][11] The defi nitive treatment of a dentoalveolar abscess is drainage and removal of the cause of the infection. 14,17,18,[29][30][31][32][33][34][35][36][37][38][39] In the majority of cases this is the only treatment required.…”

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

“…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.…”

“…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. 9 In addition, the destruction of a patient's commensal fl ora which occurs with a prolonged course of antibiotics, together with the associated abolishment of their colonisation resistance to pathogens then allows for selection and overgrowth of resistant 'super-bug' organisms.…”