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

Abstract

Objectives The study aims to overview German dentists’ development of antibiotic and analgesic prescriptions from 2012 to 2021. Materials and methods A longitudinal database analysis was performed based on the annual reports of the “Research Institute for Local Health Care Systems” (WIdO, Berlin). Results From 2012 until 2021, dental antibiotic prescriptions fell by 17.9%. In contrast, the dental proportion of antibiotic prescriptions compared to all antibiotic prescriptions in Germany increased from 9.1 to 13.6%. Aminopenicillins enhanced their share from 35.6 to 49.4%, while clindamycin prescriptions declined from 37.8 to 23.4%. The proportion of ibuprofen prescriptions significantly increased from 60.4% in 2012 to 79.0% in 2021. Conclusions Since 2013, the most frequently prescribed antibiotic by German dentists has been amoxicillin reaching nearly half of all dental antibiotic prescriptions in 2021. Simultaneously, the proportion of clindamycin has steadily decreased, but the level is still high compared to international data. During the past decade, ibuprofen as a first-line analgesic in German dentistry was continuously gaining in importance. Clinical relevance Aminopenicillins have the best risk–benefit balance in dentistry, but the use of antibiotics generally must be limited only to cases of severe infections or compromised patients. Pre-existing diseases or permanent medications should always be considered when choosing an analgesic.

Rising incidence of severe maxillofacial space infections in Germany

“…The German S3-guideline on odontogenic infections recommends clindamycin only as a second-line antibiotic in the presence of an allergy to penicillin group antibiotics [ 56 ]. Nevertheless clindamycin is with more than 23.4% of all antibiotic prescriptions still the second most prescribed antibiotic among dentists in Germany [ 57 ]. In contrast to Germany clindamycin is rarely dentally prescribed in other industrialized countries like Great Britain, Norway or Canada [ 58 – 60 ].…”