Low adherence to antibiotic prescribing guidelines among US dentists
MedWire News: Adherence to antibiotic prescribing guidelines is low among US dentists treating children, show study findings.
Inappropriate use of antibiotics has led to a rise in the incidence of antibiotic resistance among bacteria, including those found in the oral flora, explain the authors.
The American Academy of Pediatric Dentistry and the American Dental Association have developed guidelines for the use of antibiotics within dentistry. However, it is not known how well these guidelines are adhered to by practicing dentists.
In the current study, Jessica Lee (University of North Carolina, Chapel Hill, USA) and colleagues performed a cross-sectional survey of general and pediatric dentists attending continuing education courses.
The survey consisted of five clinical case scenarios, including antibiotic-prescribing decisions, in a self-administered questionnaire format. Scenarios one to three were in-office scenarios, and scenarios four and five were weekend scenarios. The responses of the participants were compared with the guidelines to determine adherence.
A total of 280 dentists attended the identified meetings, and 154 dentists agreed to participate (55% response rate). The majority of respondents were male (66%), their mean age was 43 years, and they had been practicing for an average of 19 years (range: 1-43). Approximately 30% of respondents were pediatric dentists and the remaining were general dentists who treated children.
For the in-office scenarios, adherence to antibiotic prescribing guidelines was low, at 10-42%. The level of adherence was even lower for the two weekend scenarios, at 14-17%.
When analyzing the data for factors associated with prescribing practices, dentists who reported prescribing antibiotics more frequently were significantly less likely to adhere to guidelines for three of the scenarios (two in office, one weekend), and those dentists practicing in a rural setting were significantly less likely to adhere to guidelines for two scenarios (both in office).
For scenario three, dentists who had completed postgraduate education (51%) were significantly more likely to have adhered to guidelines then those who had not.
Reporting in the Journal of the American Dental Association, Lee and colleagues state: "The results of this study show a low adherence among general and pediatric dentists to professional guidelines for prescribing antibiotics for odontogenic infections in children.
"The guidelines might be more helpful if they contained representative clinical cases to illustrate recommended prescribing patterns." They conclude that "clearer, more specific guidelines may lead to improved adherence among dentists."
By Iain Bartlett