A study of prophylactic antibiotic prescribing in National Health Service general dental practice in England.
OBJECTIVE
To study the use of prophylactic antibiotics by general dental practitioners.


METHODS
A postal questionnaire of National Health Service (NHS) general dental practitioners in ten English Health Authorities.


METHODS
General dental practitioners (GDPs) (1544) contracted to provide NHS treatment in the Health Authorities of Liverpool, Wirral, Oxfordshire, Buckinghamshire, Nottingham, North Nottinghamshire, Sheffield, Newcastle, Northumberland and North Tyneside.


METHODS
The questionnaires were analysed and the responses to each question expressed as absolute frequencies.


RESULTS
Responses to the questionnaires were received from 929 (60.1%) practitioners. Over 40% of general dental practitioners would prescribe prophylactic antibiotics for patients with no relevant medical history for minor oral surgery to prevent postoperative infection. Amoxicillin was the predominant choice of antibiotic in this situation. Between 15-67% of GDPs failed to prescribe prophylactic antibiotics for at risk medically compromised patients. GDPs also prescribed for patients with a medical history not known to be at risk from dental procedures. Over 50% of GDPs however, would seek specialist advice about prophylaxis if they were unsure of the indications and over 90% of GDPs indicated they would use the current recommended regime for antibiotic prophylaxis for patients at risk of infective endocarditis.


CONCLUSIONS
The evidence from this study suggests that a significant number of the practitioners surveyed prescribe prophylactic antibiotics inappropriately, both for surgical procedures and for patients at risk from endocarditis. There is also evidence that practitioners prescribe antibiotic prophylaxis for clinical procedures and medical conditions for which there is little evidence. The results suggest that there is a need for the development of guidelines for practitioners on the appropriate prophylactic use of antibiotics.
Palmer
N A
NA
Department of Clinical Dental Sciences, University of Liverpool.
Pealing
R
R
Ireland
R S
RS
Martin
M V
MV
D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002981:Clindamycin / Q000008:administration & dosage; D017742:Dental Care for Chronically Ill / Q000706:statistics & numerical data*; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D004917:Erythromycin / Q000008:administration & dosage; D005792:General Practice, Dental / Q000706:statistics & numerical data*; D006801:Humans; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D013218:State Dentistry / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D019564:Unnecessary Procedures / Q000706:statistics & numerical data
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D004917:Erythromycin; D000658:Amoxicillin