Population-based Assessment of Antibiotics Prescribing by Dentists in Manitoba – A Longitudinal Analysis
Background: Antibiotic surveillance/stewardship programs have become important tools to promote optimal antibiotic use. Dental prescribing of antibiotics is a significant contributor to overall antibiotic use but has received limited assessment and review at the population level. Methods: Antibiotic prescriptions dispensed from 2014-2019 were evaluated in this longitudinal population–based study conducted in Manitoba, Canada. Antibiotic rates were adjusted for population numbers (per 1000 persons). Linear regression was used to assess trends over time for dentists and physicians. Results: Over the study period, 405,124 antibiotic prescriptions written by dentists were dispensed, representing 9.1% of all antibiotic prescriptions. Physician antibiotic prescribing dropped over time while dentist prescribing remained unchanged (60.1 prescriptions/1000 persons). More than a quarter (27.0%) had potentially inappropriate durations longer than a week. Penicillins were most commonly prescribed (amoxicillin (64.1%), penicillin V (15.0%)). While limited prescriptions were written for the broader spectrum amoxicillin/clavulanate (1.9%), there was a modest increase over time of 12.5% per year (p<0.0015). Analysis by region and income showed relatively consistent results except for northern remote regions where higher rates of dental prescribing were seen. Conclusions: Dental prescribing of antibiotics in Manitoba is stable but higher than national averages with some indications of increased use of broad-spectrum antibiotics. This is in contrast to a significant decline of overall antibiotic prescribing by physicians. Practical Implications: Current data suggest that limiting prescription duration, evaluating the need for a prescription, and increasing scrutiny of the need for broad-spectrum antibiotics may improve the overall quality of dental antibiotic prescribing.
Antibiotics, Dentists, Prescriptions