Assessment of Inappropriate Antibiotic Prescribing Among a Large Cohort of General Dentists in the United States

Details

• Alternative Title:
  J Am Dent Assoc
• Personal Author:
  Durkin, Michael J. ; Feng, Qianxi ; Warren, Kyle ; Lockhart, Peter B. ; Thornhill, Martin H. ; Munshi, Kiraat D. ; Henderson, Rochelle R. ; Hsueh, Kevin ; Fraser, Victoria J.
• Corporate Authors:
  for the CDC Prevention Epicenters
• Description:
  Background
  
  The purpose of this study is to assess dental antibiotic prescribing trends over time, quantify the number and types of antibiotics dentists prescribe inappropriately, and estimate the excess healthcare costs of inappropriate antibiotic prescribing using a large cohort of general dentists in the United States (U.S.).
  
  Methods
  
  We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between 1/1/2013 and 12/31/2015 using data from Express Scripts, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription.
  
  Results
  
  Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. Over the three year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% CI: 0.14%–0.50%; p=0.001).
  
  Conclusions
  
  Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time.
  
  Practical Implications
  
  Based on these authors’ definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses using chart review, administrative datasets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists.
  
  
• Subjects:
  Anti-Bacterial Agents Cohort Studies Dentists Humans Inappropriate Prescribing United States
• Source:
  J Am Dent Assoc. 149(5):372-381.e1
• Pubmed ID:
  29703279
• Pubmed Central ID:
  PMC5995471
• Document Type:
  Journal Article
• Funding:
  U54 CK000609/CK/NCEZID CDC HHSUnited States/ ; U54 CK000162/CK/NCEZID CDC HHSUnited States/ ; U54 CK000482/CK/NCEZID CDC HHSUnited States/ ; UL1 TR002345/TR/NCATS NIH HHSUnited States/ ; KL2 TR000450/TR/NCATS NIH HHSUnited States/ ; L30 AI133778/AI/NIAID NIH HHSUnited States/ ; U54CK000482/ACL/ACL HHSUnited States/ ; KL2 TR002346/TR/NCATS NIH HHSUnited States/ ; UL1 TR000448/TR/NCATS NIH HHSUnited States/
• Volume:
  149
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:039aad165ed781333a979277625a27ab2427a529fdf6db4f62c5ca4dc03d81d8
• Download URL:
  https://stacks.cdc.gov/view/cdc/55845/cdc_55845_DS1.pdf
• File Type:
  [PDF - 207.09 KB ]