Antibiotic Prescribing in Dental Medicine—Best Practices for Successful Implementation
(2024) In Tropical Medicine and Infectious Disease 9(2).- Abstract
With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial prescriptions. In this narrative review, we have analyzed the current state of the knowledge, attitudes, and practice regarding antimicrobial use among dental professionals, and we have identified a set of seven recurring themes that drive inappropriate antibiotic prescribing in dental medicine. These include: 1. Prescribing antibiotics to delay or avoid dental treatment. 2. Overlooking the 5Ds—dental treatment (source control), dental condition (indication), drug (antibiotic choice), dose,... (More)
With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial prescriptions. In this narrative review, we have analyzed the current state of the knowledge, attitudes, and practice regarding antimicrobial use among dental professionals, and we have identified a set of seven recurring themes that drive inappropriate antibiotic prescribing in dental medicine. These include: 1. Prescribing antibiotics to delay or avoid dental treatment. 2. Overlooking the 5Ds—dental treatment (source control), dental condition (indication), drug (antibiotic choice), dose, and duration. 3. Relying on education from the distant past and on previous experience. 4. The heterogeneity of (too many) guideline recommendations leads to confusion and over-prescribing. 5. Decreased access to guideline information in private practice. 6. Psychological factors such as pressure to prescribe, comfort prescribing and the weekend effect, and 7. Feeling removed from antimicrobial resistance and externalizing responsibility. Based on the existing knowledge, we propose a framework based on four key pillars for focused intervention: 1. Education. 2. Internalizing responsibility. 3. Recognizing recurring counter-productive practices, and 4. Addressing recurring counter-productive practices. This framework can be applied in different dental settings to ensure best practices for the successful implementation of rational antimicrobial prescribing.
(Less)
- author
- Săndulescu, Oana ; Preoțescu, Liliana Lucia ; Streinu-Cercel, Adrian ; Şahin, Gülşen Özkaya LU and Săndulescu, Mihai
- organization
- publishing date
- 2024-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antibiotic resistance, antibiotics, antimicrobial use, dentistry, rational use
- in
- Tropical Medicine and Infectious Disease
- volume
- 9
- issue
- 2
- article number
- 31
- publisher
- MDPI AG
- external identifiers
-
- pmid:38393120
- scopus:85185910897
- ISSN
- 2414-6366
- DOI
- 10.3390/tropicalmed9020031
- language
- English
- LU publication?
- yes
- id
- 4851be24-a29a-470c-9dc2-2325a25ed8dc
- date added to LUP
- 2024-03-25 12:38:49
- date last changed
- 2024-04-22 14:53:30
@article{4851be24-a29a-470c-9dc2-2325a25ed8dc,
abstract = {{<p>With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial prescriptions. In this narrative review, we have analyzed the current state of the knowledge, attitudes, and practice regarding antimicrobial use among dental professionals, and we have identified a set of seven recurring themes that drive inappropriate antibiotic prescribing in dental medicine. These include: 1. Prescribing antibiotics to delay or avoid dental treatment. 2. Overlooking the 5Ds—dental treatment (source control), dental condition (indication), drug (antibiotic choice), dose, and duration. 3. Relying on education from the distant past and on previous experience. 4. The heterogeneity of (too many) guideline recommendations leads to confusion and over-prescribing. 5. Decreased access to guideline information in private practice. 6. Psychological factors such as pressure to prescribe, comfort prescribing and the weekend effect, and 7. Feeling removed from antimicrobial resistance and externalizing responsibility. Based on the existing knowledge, we propose a framework based on four key pillars for focused intervention: 1. Education. 2. Internalizing responsibility. 3. Recognizing recurring counter-productive practices, and 4. Addressing recurring counter-productive practices. This framework can be applied in different dental settings to ensure best practices for the successful implementation of rational antimicrobial prescribing.</p>}},
author = {{Săndulescu, Oana and Preoțescu, Liliana Lucia and Streinu-Cercel, Adrian and Şahin, Gülşen Özkaya and Săndulescu, Mihai}},
issn = {{2414-6366}},
keywords = {{antibiotic resistance; antibiotics; antimicrobial use; dentistry; rational use}},
language = {{eng}},
number = {{2}},
publisher = {{MDPI AG}},
series = {{Tropical Medicine and Infectious Disease}},
title = {{Antibiotic Prescribing in Dental Medicine—Best Practices for Successful Implementation}},
url = {{http://dx.doi.org/10.3390/tropicalmed9020031}},
doi = {{10.3390/tropicalmed9020031}},
volume = {{9}},
year = {{2024}},
}