Antibiotic prescriptions vary by season, specialty

2018 08 03 21 38 7808 Iadr Logo 2018 London 400

Dentists prescribe millions of antibiotics, but prescription trends vary by dental specialty and time of year, according to new research presented at the recent 2018 International Association of Dental Research (IADR ) meeting in London.

Researchers looked at dental specialists' antibiotic prescription data to evaluate long-term prescribing trends. They found that antibiotic prescriptions by pediatric dentists and orthodontists peaked during cold and flu season, which may represent an inappropriate use of antibiotics. Qianxi Feng, MPH, of Washington University in St. Louis, presented their findings at the IADR meeting.

"Reducing inappropriate antibiotic prescribing has been a major national quality improvement initiative by United States public health agencies," the researchers wrote in their study abstract. "The purpose of this study is to assess longitudinal antibiotic prescribing practices among dental specialties in the U.S."

The number of prescriptions haven't changed

Antibiotic-resistant bacteria are a major healthcare concern. The U.S. Centers for Disease Control and Prevention estimates that at least 2 million illnesses and 240,000 deaths are caused by antibiotic resistance and that up to half of antibiotics are not optimally prescribed.

“These results demonstrate opportunities to improve antibiotic prescribing among dental specialties within the U.S.”
— Qianxi Feng, MPH, and colleagues

Outpatient medical professionals have been steadily reducing the number of antibiotic prescriptions over time, but the same is not true for general dentists. Therefore, the researchers were curious about dental specialists' antibiotic prescription habits. To find out, they analyzed data from Express Scripts Holding, a pharmacy benefits manager.

Between January 2013, and December 2015, dental specialists prescribed 2.4 million antibiotics to 38 million patients, and, unlike in medicine, prescriptions from dental specialists remained flat.

"This is the first description of dental specialist prescribing in the U.S.," Feng and colleagues wrote. "In contrast to medicine, overall prescribing practices remained stable over time."

Oral and maxillofacial surgeons prescribed the most antibiotics of any specialty, followed by periodontists and endodontists. Furthermore, pediatric dentists prescribed significantly more antibiotics in the spring, and orthodontics prescribed significantly more antibiotics in the fall.

"Similar seasonality in antibiotic prescribing has been observed in medical providers and may represent inappropriate treatment of upper respiratory viral infections," the researchers wrote. "These results demonstrate opportunities to improve antibiotic prescribing among dental specialties within the U.S."

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