US dentists prescribe twice as many antibiotics as dentists in Australia
A study assessing the prescribing habits of dentists in Australia, British Columbia, Europe and the United States found that dentists in the U.S. 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, PhD, professor of dentistry at the University of Manchester in England, organized 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 U.S., Thompson spoke about similar work in the United Kingdom, and Leanne Teoh, PhD, 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% of all antibiotics prescribed across international health care and 80% are not in accordance with guidelines in the U.K. and U.S. So, this study was born,” Thompson told Healio.
The three researchers and several other colleagues compared overall prescription-based rates and prescription-based rates by antibiotic class, adjusted by population, between Jan. 1 and Dec. 31, 2017, in Australia, England, the U.S. and British Columbia.
Overall, they found that dentists in the U.S. had the highest antibiotic prescribing rate per 1,000 population (72.6 antibiotic items per 1,000 population) and Australia had the lowest rate (33.2 antibiotic items per 1,000 population). According to the study, penicillins — particularly amoxicillin — were the most frequently prescribed class for all countries (highest at 80.5% in British Columbia and lowest at 66.8% in England), whereas the second most common agents prescribed were clindamycin in the U.S. (14.3%) and British Columbia (12.4) and metronidazole in Australia (13.2%) and England (28.4%).
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. 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,” Thompson said. “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 minimizing the use of broad-spectrum agents and taking account of the WHO AWaRe guidelines.”