Dentists Prescribe Excess Antibiotics in Children

A new survey suggests that most dentists do not follow recommended professional guidelines, and tend to overprescribe antibiotics in children.

Researchers at the University of North Carolina (UNC; Chapel Hill, USA) conducted a survey that consisted of a self-administered questionnaire describing five clinical case scenarios that included antibiotic-prescribing decisions. Of the almost 300 dentists to whom the surveys were sent, 154 dentists responded, of whom 48 (31%) were pediatric dentists and 106 (69%) were general dentists; the mean age of respondents was 47 years, and the mean number of years in practice was 19. The researchers then compared the practitioners’ responses for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry (AAPD; Chicago, IL, USA) and the American Dental Association (ADA).

The results showed that dentists’ adherence to professional guidelines for prescribing antibiotics for odontogenic infections in children was low. Across the three in-office clinical case scenarios, adherence to professional prescribing guidelines ranged from 10% to 42%. For the two weekend scenarios, overall adherence to the professional prescribing guidelines dropped to 14%-17%. Dentists who had completed postgraduate education were more likely to have adhered to published guidelines in prescribing antibiotics. The study was published in the January 2012 issue of the Journal of the American Dental Association (JADA).

“In some of the scenarios, dentists who had completed advanced education, such as residency, were more likely to adhere to the guidelines. Rural dentists were less likely to adhere to them, and dentists who see more than 15 children per week were also more likely to hand out the prescriptions,” concluded lead author associate professor of pediatric dentistry Jessica Lee, DDS, MPH, and colleagues. “Dentists also departed from the guidelines in showing a willingness to prescribe antibiotics over the telephone.”

According to the AAPD professional guidelines, dentists should consider prescribing antibiotics when a patient has facial swelling, either with or without pain, or radiographic evidence of pathology, or a combination of the three symptoms.

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