title: Antimicrobial prescribing by dentists in Wales, UK: findings of the first cycle of a clinical audit.
abstract: Objective To describe the findings of the first cycle of a clinical audit of antimicrobial use by general dental practitioners (GDPs).Setting General dental practices in Wales, UK.Subjects and methods Between April 2012 and March 2015, 279 GDPs completed the audit. Anonymous information about patients prescribed antimicrobials was recorded. Clinical information about the presentation and management of patients was compared to clinical guidelines published by the Scottish Dental Clinical Effectiveness Programme (SDCEP).Results During the data collection period, 5,782 antimicrobials were prescribed in clinical encounters with 5,460 patients. Of these 95.3% were antibiotic preparations, 2.7% were antifungal agents, and 0.6% were antivirals. Of all patients prescribed antibiotics, only 37.2% had signs of spreading infection or systemic involvement recorded, and 31.2% received no dental treatment. In total, 79.2% of antibiotic, 69.4% of antifungal, and 57.6% of antiviral preparations met audit standards for dose, frequency, and duration. GDPs identified that failure of previous local measures, patient unwillingness or inability to receive treatment, patient demand, time pressures, and patients' medical history may influence their prescribing behaviours.Conclusions The findings of the audit indicate a need for interventions to support GDPs so that they may make sustainable improvements to their antimicrobial prescribing practices.
authors.affiliation: Dental Public Health, Cardiff and Vale University Health Board.
authors.forename: A L
authors.initials: AL
authors.lastname: Cope
authors.affiliation: Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), School of Social Sciences, Cardiff University, 12 Museum Place, Cardiff, CF10 3BG.
authors.forename: E
authors.initials: E
authors.lastname: Barnes
authors.affiliation: Health and Social Services Group, Welsh Government, Cathays Park, Cardiff, CF10 3NQ.
authors.forename: E P
authors.initials: EP
authors.lastname: Howells
authors.affiliation: Postgraduate Dental Education, Wales Deanery, 8th Floor, Neuadd Meirionnydd, Heath Park, CF14 4YS.
authors.forename: A M
authors.initials: AM
authors.lastname: Rockey
authors.affiliation: Wales Deanery, 8th Floor, Neuadd Meirionnydd, Heath Park, CF14 4YS.
authors.forename: A J
authors.initials: AJ
authors.lastname: Karki
authors.affiliation: Dental Public Health, Public Health Wales, Dental Public Health, Public Health Wales, Temple of Peace and Health, Cardiff, CF10 3NW;
authors.forename: M J
authors.initials: MJ
authors.lastname: Wilson
authors.affiliation: Oral Medicine School of Dentistry; Cardiff University, University Dental Hospital, Heath Park, Cardiff, CF14 4XY.
authors.forename: M A O
authors.initials: MA
authors.lastname: Lewis
authors.affiliation: Oral Medicine School of Dentistry; Cardiff University, University Dental Hospital, Heath Park, Cardiff, CF14 4XY.
authors.forename: J G
authors.initials: JG
authors.lastname: Cowpe
mesh_terms: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D054869:Clinical Audit; D003815:Dentists; D006801:Humans; D019239:Practice Patterns, Dentists'; D014852:Wales
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents