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Assessment of Inappropriate Antibiotic Prescribing Among a Large Cohort of General Dentists in the United States
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5 2018
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Source: J Am Dent Assoc. 149(5):372-381.e1
[PDF-207.09 KB]
Details:
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Alternative Title:J Am Dent Assoc
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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.
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Pubmed ID:29703279
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Pubmed Central ID:PMC5995471
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Volume:149
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Issue:5
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