TY - JOUR
T1 - Assessment of inappropriate antibiotic prescribing among a large cohort of general dentists in the United States
AU - Centers for Disease Control and Prevention Epicenters
AU - Durkin, Michael J.
AU - Feng, Qianxi
AU - Warren, Kyle
AU - Lockhart, Peter B.
AU - Thornhill, Martin H.
AU - Munshi, Kiraat D.
AU - Henderson, Rochelle R.
AU - Hsueh, Kevin
AU - Fraser, Victoria J.
N1 - Publisher Copyright:
© 2018 American Dental Association
PY - 2018/5
Y1 - 2018/5
N2 - Background: The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. Methods: We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Results: Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P =.001). Conclusions: Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. Practical Implications: From these authors’ definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists.
AB - Background: The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. Methods: We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Results: Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P =.001). Conclusions: Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. Practical Implications: From these authors’ definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists.
KW - Antibiotics
KW - dentistry
KW - epidemiology
KW - prophylaxis
KW - public health
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85045739076&partnerID=8YFLogxK
U2 - 10.1016/j.adaj.2017.11.034
DO - 10.1016/j.adaj.2017.11.034
M3 - Article
C2 - 29703279
AN - SCOPUS:85045739076
SN - 0002-8177
VL - 149
SP - 372-381.e1
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
IS - 5
ER -