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A study of therapeutic antibiotic prescribing in National Health Service general dental practice in England.

AbstractOBJECTIVE:
To study the therapeutic prescribing of antibiotics by general dental practitioners.
DESIGN:
A postal questionnaire of National Health Service general dental practitioners in ten English Health Authorities.
SUBJECTS:
General dental practitioners (1,544) contracted to provide NHS treatment in the Health Authorities of Liverpool, Wirral, Oxfordshire, Buckinghamshire, Nottingham, North Nottinghamshire, Sheffield, Newcastle, Northumberland and North Tyneside.
MAIN OUTCOME MEASURES:
The questionnaires were analysed and the responses to each question expressed as absolute frequencies.
RESULTS:
Responses to the questionnaire were received from 929 (60.1%) practitioners. More than 95% of practitioners recognised the need for prescribing antibiotics where there was evidence of spreading infection. Some practitioners (12.5%) prescribed antibiotics for acute pulpitis and (3.3%) for chronic marginal gingivitis. Antibiotics were prescribed by practitioners before drainage of acute abscesses (69%) and by 23% after drainage. Practitioners were generally not influenced by patient's expectations of receiving antibiotics (92%), but would prescribe when under pressure of time (30.3%), if they were unable to make a definitive diagnosis (47.3%), or if treatment had to be delayed (72.5%). Amoxicillin was the most frequently prescribed antibiotic used for most clinical conditions apart from pericoronitis, acute ulcerative gingivitis and dry sockets where metronidazole was the drug of choice. There was a wide variety of dosage, frequency and duration for all the antibiotics used in the treatment of acute dental infections.
CONCLUSIONS:
The results obtained from this questionnaire support the conclusion that the therapeutic prescribing of antibiotics in general dental practice varies widely and is suboptimal. There is a clear need for the development of prescribing guidelines and educational initiatives to encourage the rational and appropriate use of the antibiotics in National Health Service general dental practice.
AuthorsN A Palmer, R Pealing, R S Ireland, M V Martin
JournalBritish dental journal (Br Dent J) Vol. 188 Issue 10 Pg. 554-8 (May 27 2000) ISSN: 0007-0610 [Print] England
PMID10870281 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Penicillins
  • Metronidazole
  • Amoxicillin
Topics
  • Abscess (surgery)
  • Acute Disease
  • Amoxicillin (therapeutic use)
  • Anti-Bacterial Agents (therapeutic use)
  • Anti-Infective Agents (therapeutic use)
  • Bacterial Infections (drug therapy)
  • Chronic Disease
  • Dentist-Patient Relations
  • Drainage
  • Drug Prescriptions (statistics & numerical data)
  • Drug Utilization (statistics & numerical data)
  • Dry Socket (drug therapy)
  • England (epidemiology)
  • Female
  • General Practice, Dental (statistics & numerical data)
  • Gingivitis (drug therapy)
  • Gingivitis, Necrotizing Ulcerative (drug therapy)
  • Humans
  • Male
  • Metronidazole (therapeutic use)
  • Penicillins (therapeutic use)
  • Pericoronitis (drug therapy)
  • Pulpitis (drug therapy)
  • State Medicine (statistics & numerical data)
  • Surveys and Questionnaires

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