US dentists prescribe twice as many antibiotics as dentists in Australia

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dental antibiotic prescriptions
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A study assessing the prescribing habits of dentists in Australia, British Columbia, Europe and the United States found that dentists in the US prescribed the most antibiotics per population.

They prescribed twice as many antibiotics as dentists in Australia, who prescribed the fewest, researchers reported.

The study came together at the 2019 International Association for Dental Research general session in Vancouver, where Wendy Thompson, professor of dentistry at the University of Manchester in England, organised and chaired a symposium on dental antimicrobial stewardship.

During the symposium, Katie J. Suda, PharmD, from the Veterans Affairs Pittsburgh Healthcare System, gave a talk about work she was leading in the US. Professor Thompson spoke about similar work in the United Kingdom, and Leanne Teoh, from the Melbourne Dental School in Australia, was in the audience.

“In the margins of the conference, we got together to discuss how surprised we were that there is so little research about dental antimicrobial stewardship even though dentists are responsible for around 10 per cent of all antibiotics prescribed across international health care and 80 per cent are not in accordance with guidelines in the UK and US. So, this study was born,” Professor Thompson said.

The three researchers and several other colleagues compared overall prescription-based rates and prescription-based rates by antibiotic class, adjusted by population, between 1 January and 31 December 2017, in Australia, England, the US and British Columbia.

Overall, they found that dentists in the US had the highest antibiotic prescribing rate per 1000 population (72.6 antibiotic items per 1000 population) and Australia had the lowest rate (33.2 antibiotic items per 1000 population).

According to the study, penicillins—particularly amoxicillin— were the most frequently prescribed class for all countries (highest in British Columbia and lowest in England), whereas the second most common agents prescribed were clindamycin in the US and British Columbia and metronidazole in Australia and England

The researchers said the different rates did not seem to be explained by differences in dental health, but may be related to differences in the prophylactic use of dental antibiotics aiming to protect people at risk for distance site infections during operative dental procedures.

“Dental antibiotic stewardship programs are urgently needed worldwide,” Professor Thompson said. 

“As highlighted in the FDI World Dental Federation white paper on the role of dental teams to tackling antibiotic resistance, no one-size-fits-all solution is available for dentistry.

“The context in which dental care is provided around the world varies greatly, so each nation must ensure it has guidelines appropriate to the local context, whilst minimising the use of broad-spectrum agents and taking account of the WHO AWaRe guidelines.”

This article is sourced from Healio.

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