title: The impact of clinical audit on antibiotic prescribing in general dental practice.
abstract: OBJECTIVE
  To reduce the number of antibiotics inappropriately prescribed by general dental practitioners, and to increase overall prescription accuracy.
  
  
  METHODS
  A prospective clinical audit carried out between September and March of 2002-3 and 2003-4.
  
  
  METHODS
  General dental practices in Eastern England.
  
  
  METHODS
  The pre-audit antibiotic prescribing practices of 212 general dental practitioners were recorded over an initial six week period. On each occasion this included which antibiotic had been chosen, together with its dose, frequency and duration, as well as the clinical condition and reason for which the prescription had been raised. When related to prophylaxis, the patient's medical history was also noted. Following education on contemporary prescribing guidelines, presentations which illustrated the practitioners' previous errors, and the agreement of standards to be achieved, the process was repeated for another six weeks, and the results compared.
  
  
  RESULTS
  In the pre-audit period, 2,951 antibiotic prescriptions were issued, and during the audit this was reduced by 43.6% to 1,665. The majority were for therapeutic reasons, with only 10.5% and 13.6% for medical prophylaxis during the pre-audit and audit periods respectively. Over both periods, amoxicillin and metronidazole were the two most commonly prescribed antimicrobials (63.4% and 21.2% respectively). In the pre-audit period, only 43% of all prescriptions were error free in dose, frequency, and/or duration of use, but this rose significantly to 78% during the audit. Equally, using contemporary published guidelines, out of all the prescriptions made in the pre-audit period, only 29.2% were deemed to be justified, as compared to 48.5% during the audit.
  
  
  CONCLUSIONS
  Clinical audit, in conjunction with education, and prescribing guidelines can favourably change antibiotic prescribing patterns among general dental practitioners.
authors.affiliation: Orthodontic Department, Essex County Hospital, Lexden Road, Colchester C03 3NB. racchate@rcsed.ac.uk
authors.forename: R A C
authors.initials: RA
authors.lastname: Chate
authors.forename: S
authors.initials: S
authors.lastname: White
authors.forename: L R O
authors.initials: LR
authors.lastname: Hale
authors.forename: A P
authors.initials: AP
authors.lastname: Howat
authors.forename: J
authors.initials: J
authors.lastname: Bottomley
authors.forename: J
authors.initials: J
authors.lastname: Barnet-Lamb
authors.forename: J
authors.initials: J
authors.lastname: Lindsay
authors.forename: T I
authors.initials: TI
authors.lastname: Davies
authors.forename: J M
authors.initials: JM
authors.lastname: Heath
mesh_terms: D000900:Anti-Bacterial Agents; D019230:Dental Audit / Q000379:methods*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004739:England; D006801:Humans; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents