The use of antibiotics in acute oral health patients presenting at public dental clinics in the Western Sydney region

Abstract

Background There is a limited need for antibiotics when treating oral health problems, yet they are often prescribed, increasing risk of antimicrobial resistance (AMR). With AMR a threat to public health, the objectives of this study were to assess the frequency, suitability, and factors associated with antibiotic prescriptions for acute dental problems across Greater Western Sydney public dental clinics. Methods Patients’ reason for attending, details of any antibiotics use, and the treating dental practitioner’s clinical examination and diagnosis were compared to current prescribing guidelines, and logistic regression was used to identify predictors of antibiotic prescription. Results In all, 1,071 patients participated in the study, and 15.9% reported to using antibiotics for their dental problem. Over three-quarters obtained the antibiotics from their general medical practitioner (GMP). A high prevalence of antibiotics were not indicated for the patient’s complaint (71.8%) including for those with a history of extraction, pain, or intraoral swelling, who had significantly higher odds of antibiotic prescription (OR > 9). The antibiotic type prescribed was generally suitable. Conclusions In summary, the data suggest that the majority of antibiotics were inappropriately prescribed for the patient’s dental complaints and there is a need for interventions to improve compliance with antibiotic prescribing guidelines.

Perceptions of general practitioners towards managing dental presentations in Australia: a qualitative study

“…In general, they are only needed when a tooth infection shows signs of systemic spread (Therapeutic Guidelines 2019). However, multiple studies have shown that GPs tend to prescribe antibiotics as treatment for dental conditions (Anderson et al 2000;Cope et al 2015;Nguyen et al 2023). An Australian case-vignette study of 30 GPs who worked in rural Queensland, Tasmania and South Australia between 2013 and 2014 showed that GPs tend to prescribe antibiotics and short-term pain relief for dental conditions, including toothaches, dental abscesses and acute orofacial pain (Park et al 2022).…”