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Antimicrobial prescribing by Belgian dentists in ambulatory care, from 2010 to 2016. | LitMetric

Antimicrobial prescribing by Belgian dentists in ambulatory care, from 2010 to 2016.

Int Dent J

Sciensano, Healthcare-associated Infections & Antimicrobial Resistance, Brussels, Belgium.

Published: December 2019

AI Article Synopsis

  • The study analyzes antimicrobial prescribing patterns among Belgian dentists from 2010 to 2016, using reimbursement data to assess usage in defined daily doses (DDDs) and prescriptions per population.
  • Results showed a 6.3% increase in the DDD rate for broad-spectrum antibiotics like amoxicillin, despite a 6.7% decline in prescriptions per dentist, indicating a concerning trend towards using more broad-spectrum drugs.
  • The findings highlight an urgent need for improved clinical practice guidelines for dentists, as over-prescription of broad-spectrum antibiotics may contribute to antibiotic resistance.

Article Abstract

Objectives: To describe antimicrobial prescribing by Belgian dentists in ambulatory care, from 2010 until 2016.

Materials And Methods: Reimbursement data from the Belgian National Institute for Health and Disability Insurance were analysed to evaluate antimicrobial prescribing (WHO ATC-codes J01/P01AB). Utilisation was expressed in defined daily doses (DDDs), and in DDDs and packages per 1000 inhabitants per day (DID and PID, respectively). Additionally, the number of DDD and packages per prescriber was calculated.

Results: In 2016, the dentistry-related prescribing rate of 'Antibacterials for systemic use' (J01) and 'Antiprotozoals' (P01AB) was 1.607 and 0.014 DID, respectively. From 2010 to 2016, the DID rate of J01 increased by 6.3%, while the PID rate declined by 6.7%. Amoxicillin and amoxicillin with an enzyme inhibitor were the most often prescribed products, followed by clindamycin, clarithromycin, doxycycline, azithromycin and metronidazole. The proportion of amoxicillin relative to amoxicillin with an enzyme inhibitor was low. The narrow-spectrum antibiotic penicillin V was almost never prescribed.

Conclusions: Antibiotics typically classified as broad- or extended-spectrum were prescribed most often by Belgian dentists during the period 2000-2016. Although the DID rate of all 'Antibacterials for systemic use' (J01) increased over the years, the number of prescriptions per dentist decreased since 2013. The high prescription level of amoxicillin with an enzyme inhibitor is particularly worrying. It indicates that there is a need for comprehensive clinical practice guidelines for Belgian dentists.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379087PMC
http://dx.doi.org/10.1111/idj.12512DOI Listing

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