Promoting prudent prescribing of antibiotics for dental problems in primary care
Reducing unnecessary prescribing to minimise the emergence of antimicrobial resistant bacteria.
Antimicrobial resistance (when infections can no longer be treated with existing available medications) poses a massive threat to public health. The overuse of antibiotics is a major cause of antimicrobial resistance so it is important that antibiotics are prescribed judiciously. That means the right drug, at the right dose, for the right duration, and crucially, only when they are really needed.
Ivor Chestnutt, a Professor and Honorary Consultant in dental public health, and Anwen Cope, a Specialty Trainee in dental public health, work with collaborators in the School of Medicine to understand how antibiotics are used in the management of dental problems in primary care in the UK.
Uncovering the issues
Dentists are responsible for 1 in 10 primary care prescriptions for antibiotics in the UK. Many of these are for conditions such as dental abscesses, which may be more effectively managed using dental treatments such as tooth extraction or root canal treatment.
Research undertaken by the University indicated that as much as 80% of antibiotics prescribed by dentists in Wales were not prescribed in line with current guidelines.
One of the main areas that this research seeks to understand is what factors can influence primary care clinicians’ decisions to prescribe antibiotics for patients with dental problems.
Improving antibiotic prescribing today can help make sure antibiotics are still effective for years to come. All parts of healthcare have a role to play in ensuring stewardship of existing antimicrobials.
Research for change
In a recent cross-sectional study conducted among general dental practitioners in Wales we found that patient requests for antibiotics, and pressures of clinical time and workload significantly increased the likelihood of a patient being prescribed an antibiotic when one was not indicated.
This knowledge will allow us to implement effective changes in primary care to promote the best use of antibiotics for dental problems.
- Cope, A. et al. 2016. Antibiotic prescribing in UK general dental practice: a cross-sectional study. Community Dentistry and Oral Epidemiology 44 (2), pp.145-153. (10.1111/cdoe.12199)
- Cope, A. et al. 2015. General practitioners' attitudes towards the management of dental conditions and use of antibiotics in these consultations: a qualitative study. BMJ Open 5 (10) e008551. (10.1136/bmjopen-2015-008551)
- Cope, A. et al. 2014. General dental practitioners' perceptions of antimicrobial use and resistance: a qualitative interview study. British Dental Journal 217 (5), pp.653-660. E9. (10.1038/sj.bdj.2014.761)