Summary
Background
Antimicrobials are commonly prescribed in dentistry. However, inappropriate antimicrobial
prescriptions are common in this field. Optimizing antimicrobial prescriptions in
dentistry requires an effective strategy for modifying prescribing behaviour.
Aim
To assess the efficacy of pharmacist-led multi-faceted intervention for the proportion
of monthly antimicrobial prescriptions in each drug group per 100 oral antimicrobial
prescriptions.
Methods
A before–after trial was performed at a university hospital outpatient dental clinic.
A pharmacist-led, multi-faceted intervention, including immediate and direct feedback
to the prescribers, an explanation of the rules of antimicrobial prescriptions for
patients with penicillin allergy, tutorials for dentistry students, and a review of
hospital-approved antimicrobials, was implemented from April 2017 to March 2022. Antimicrobials
were classified into eight groups, namely, penicillins, first- and second-generation
cephalosporins, third-generation cephalosporins, fluoroquinolones, macrolides, clindamycin,
carbapenem, and others.
Findings
In total, there were 2,643,988 visits to the outpatient dental clinic during the study
period. The monthly mean proportion of prescriptions for penicillins increased from
45.6 to 84.1 per 100 oral antimicrobial prescriptions (P<0.001) while that of third-generation cephalosporins decreased from 43.0 to 7.3 (P<0.001) from the pre-intervention to the intervention period. Moreover, the monthly
mean proportion of fluoroquinolones, macrolides, and carbapenems decreased from 11.2
to 7.44 (P<0.001).
Conclusion
The intervention modified dentists' antimicrobial prescribing behaviours, leading
to an immediate increase in the number of monthly prescriptions for penicillins and
a simultaneous decrease in the number of monthly prescriptions for third-generation
cephalosporins and other broad-spectrum, oral antimicrobials.
Keywords
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Article info
Publication history
Published online: April 21, 2023
Accepted:
April 4,
2023
Received:
February 15,
2023
Identification
Copyright
© 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
