Patterns of dental antibiotic prescribing in 2017: Australia, England, United States and British Columbia (Canada)

Wendy Thompson, Leanne Teoh, David Patrick, Colin Hubbard, Fawziah Marra, Abdullah Mamun, Allen Campbell, Katie Suda

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Objective: Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North American (U.S. and British Columbia, Canada).
Design: Population-level analysis of antibiotic prescription
Setting: Outpatient prescribing by dentists in 2017
Participants: Patients receiving an antibiotic dispensed by an outpatient pharmacy
Methods: Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country.
Results: In 2017, dentists in the United States (US) had the highest antibiotic prescribing rate per 1000 population and Australia had the lowest rate. The penicillin class, in particular amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the US and British Columbia (Canada) and metronidazole in Australia and England. Broad spectrum agents, amoxicillin-clavulanic acid and azithromycin were the highest in Australia and U.S., respectively.
Conclusion: There are extreme differences in antibiotics prescribed by dentists in Australia, England, U.S., and British Columbia. The U.S. had twice the antibiotic prescription rate compared with Australia and prescribed the most clindamycin. Significant opportunities exist for the global dental community to update their prescribing behaviour when it comes to use of second-line agents in penicillin allergic patients and contribute to international efforts to tackle antibiotic resistance. Patient safety improvements will result from optimising dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programmes are urgently needed worldwide.
Original languageEnglish
JournalInfection Control and Hospital Epidemiology
Publication statusPublished - 5 Apr 2021


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