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The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

Abstract:

Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic Resistance, antibiotic stewardship, dental infection and hygiene standards

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1111775

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References:


[1] Chief Medical Officers and Chief Veterinary Officers in Northern Ireland, Scotland and Wales, UK Five Year Antimicrobial Resistance Strategy 2013 to 2018. UK Department of Health, September 2013
[2] Public Health England, Antimicrobial prescribing and stewardship competencies. September 2013
[3] Johnson T, Hawkes J. Awareness of Antibiotic Prescribing and Resistance in Primary Dental Care. Prim Dent J. 2014 Nov; 3(4): 44-7
[4] Crighton D. Antibiotic stewardship. BDJ. 2011;211(10):443-443.
[5] Fouad A, Rivera E, Walton R. Penicillin as a supplement in resolving the localized acute apical abscess. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1996;81(5):590-595.
[6] Curran J, Kennett S, Young A. An assessment of the use of prophylactic antibiotics in third molar surgery. International Journal of Oral Surgery. 1974;3(1):1-6.
[7] Lund B, Hultin M, Tranaeus S, Naimi-Akbar A, Klinge B. Complex systematic review - Perioperative antibiotics in conjunction with dental implant placement. Clinical Oral Implants Research. 2015; 26:1-14.
[8] Palmer N. An analysis of antibiotic prescriptions from general dental practitioners in England. Journal of Antimicrobial Chemotherapy. 2000;46(6):1033-1035.
[9] Lewis M, Carmichael F, MacFarlane T, Milligan S. A randomised trial of co-amoxiclav (Augmentin) versus penicillin V in the treatment of acute dentoalveolar abscess. British Dental Journal. 1993;175(5):169-174.
[10] 23 Antimicrobial prescribing and stewardship competencies, 2016. Print.
[11] 'California is the only state with formal state-wide legislation that supports antimicrobial stewardship.' BDJ. 2015;219(7):329-329.
[12] Van Boeckel TP, Gandra S, Ashok A, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. The Lancet infect Dis 2014; 14: 742–50.
[13] Hollis A, Ahmed Z. Preserving Antibiotics, Rationally. New England Journal of Medicine. 2013;369(26):2474-2476.
[14] Davies J, Davies D. Origins and Evolution of Antibiotic Resistance. Microbiology and Molecular Biology Reviews. 2010;74(3):417-433.
[15] Lewis M, Parkhurst C, Douglas C, Martin M, Absi E, Bishop P et al. Prevalence of penicillin resistant bacteria in acute suppurative oral infection. J Antimicrob Chemother. 1995;35(6):785-791.
[16] Pankhurst C, Rautemaa-Richardson R, Seoudi N, Smith A, Wilson M. Antimicrobial resistance: Antibiotics and consultant oral microbiologist posts. BDJ. 2016;220(1):2-3.
[17] NICE antimicrobial resistance guideline. The Pharmaceutical Journal. 2015.
[18] Neu H. The Crisis in Antibiotic Resistance. Science. 1992;257(5073):1064-1073.
[19] Le Corvoisier P, Renard V, Roudot-Thoraval F, Cazalens T, Veerabudun K, Canoui-Poitrine F et al. Long-term effects of an educational seminar on antibiotic prescribing by GPs: a randomised controlled trial. br j gen pract. 2013;63(612):455-464.
[20] Arroll B. Delayed prescriptions. BMJ. 2003;327(7428):1361-1362.
[21] Ashworth M, White P, Jongsma H, Schofield P, Armstrong D. Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data. British Journal of General Practice. 2015;66(642): e40-e46.
[22] Tjernberg A. Influence of oral hygiene measures on the development of alveolitis sicca dolorosa after surgical removal of mandibular third molars. International Journal of Oral Surgery. 1979;8(6):430-434.
[23] Cabello F. Heavy use of prophylactic antibiotics in aquaculture: a growing problem for human and animal health and for the environment. Environ Microbiol. 2006;8(7):1137-1144.
[24] Ghafur A, Mathai D, Muruganathan A, et al. The Chennai declaration: a roadmap to tackle the challenge of antimicrobial resistance. Indian J Cancer 2013; 50: 71–73.
[25] Ling L, Schneider T, Peoples A, Spoering A, Engels I, Conlon B et al. A new antibiotic kills pathogens without detectable resistance. Nature. 2015;517(7535):455-459.