The impact of clinical audit on antibiotic prescribing in general dental practice.

Publisher: British Dental Journal Country of Publication: England NLM ID: 7513219 Publication Model: Print Cited Medium: Print ISSN: 0007-0610 (Print) Linking ISSN: 00070610 NLM ISO Abbreviation: Br Dent J Subsets: MEDLINE

Publication: London : British Dental Journal
Original Publication: London.

Anti-Bacterial Agents*; Dental Audit/*methods ; Drug Utilization/*statistics & numerical data; England ; Humans ; Prospective Studies

Objective: To reduce the number of antibiotics inappropriately prescribed by general dental practitioners, and to increase overall prescription accuracy.
Design: A prospective clinical audit carried out between September and March of 2002-3 and 2003-4.
Setting: General dental practices in Eastern England.
Subjects and 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.

0 (Anti-Bacterial Agents)

Date Created: 20061128 Date Completed: 20070510 Latest Revision: 20220311

20221213

10.1038/sj.bdj.4814261

17128233