Title: Antimicrobial prescribing across dental specialties at the eastman dental hospital
Abstract:
Introduction: Antimicrobials form an important adjunctive therapy within our field for treating oral infections.1 Inappropriate prescribing of antimicrobials can exacerbate the issue of antimicrobial resistance, which leads to antibiotics no longer being effective in treating even simple infections.1
Aim: To ensure antimicrobial prescriptions from the relevant dental specialties at the Eastman Dental Hospital (EDH) are consistent with current guidelines and best practice as set out by FGDP in 2020. Standard to achieve within audit: 90% of prescriptions to be appropriately prescribed in line with Faculty of General Dental Practice (FGDP) 2020 antimicrobial prescribing in dentistry guidelines.
Method: Retrospective data collection over a period of 3 months. Data was retrieved from the prescription logbook used by clinical staff from the relevant dental specialties across different floors at EDH. This information was cross referenced with patient clinical records and checked whether diagnosis, justification and prescription details were recorded. Specialties involved were Oral Surgery, Restorative Dentistry, Paediatric Dentistry, Oral Medicine and Special Care Dentistry. Prescription entries were categorised into 3 groups; Appropriate (the prescription is clinically justified and prescribed according to guidelines), Inconclusive (the prescription is clinically justified but not prescribed according to guidelines (i.e. error in choice of drug, dose, frequency or duration)), Inappropriate (the prescription is not clinically justified or no clear justification found).
Results: The total number of prescriptions recorded across all specialties at EDH was 381 and the overall percentage of prescriptions meeting the standard was 71%. Paediatric Dentistry achieved the highest percentage of appropriate prescriptions (83%). 86 prescriptions were excluded due to no evidence of the prescription being recorded in the clinical notes.
Conclusion: There was generally poor explanation of justification for a prescription being given, demonstrating a lack of contemporaneous record keeping. Going forward, we will update the logbook to include prescription details as well as a prompt on the heading to encourage clinicians to provide a reason for prescribing an antimicrobial. Additionally, we will reinforce the need to utilise the prescription record template for record keeping purposes as well as making use of electronic prescribing to improve prescribing practice amongst dental specialties.
