TY - JOUR
T1 - Longitudinal antibiotic prescribing trends among US dental specialists within a pharmacy benefits manager, 2013 through 2015
AU - Centers for Disease Control and Prevention Epicenters
AU - Durkin, Michael J.
AU - Feng, Qianxi
AU - Suda, Katie J.
AU - Lockhart, Peter B.
AU - Thornhill, Martin H.
AU - Warren, Kyle
AU - Munshi, Kiraat D.
AU - Henderson, Rochelle R.
AU - Fraser, Victoria J.
N1 - Publisher Copyright:
© 2019 American Dental Association
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/10
Y1 - 2019/10
N2 - Background: Reducing inappropriate antibiotic prescriptions (Rxs) is a major quality improvement initiative in the United States. Tracking antibiotic prescribing trends is 1 method of assessing improvement in antibiotic prescribing. The purpose of this study was to assess longitudinal antibiotic prescribing practices among dental specialists. Methods: This was a retrospective ecological longitudinal trend study. The authors calculated monthly systemic antibiotic Rx counts, and rates per 100,000 beneficiaries, from a pharmacy benefits manager in the United States from 2013 through 2015. The authors calculated average annual antibiotic Rx rates (AARs) for the 3-year study period. The authors used a quasi-Poisson regression model to analyze antibiotic Rx trends. The authors quantified seasonal trends, when present, via peak-to-trough ratios (PTTRs). Results: Dental specialists prescribed 2.4 million antibiotics to the cohort of 38 million insurance beneficiaries during the 3-year study period (AAR = 2,086 Rxs per 100,000 beneficiaries). Oral and maxillofacial surgeons prescribed the most antibiotics (1,172,104 Rxs; AAR = 1,018 Rxs per 100,000 beneficiaries), followed by periodontists (527,038 Rxs; AAR = 457 Rxs per 100,000 beneficiaries), and endodontists (447,362 Rxs; AAR = 388 Rxs per 100,000 beneficiaries). Longitudinal antibiotic prescribing trends were stable among all dental specialties in the regression models (P >.05). The authors observed substantial seasonal variation in antibiotic Rxs in 2 specialties: pediatric dentistry (PTTR, 1.18; 95% confidence interval, 1.13 to 1.25) and orthodontics and dentofacial orthopedics (PTTR, 1.41; 95% confidence interval, 1.21 to 1.71), with the highest rates of antibiotic Rxs in the spring and winter. Conclusions: Antibiotic prescribing practices for dental specialists remained stable. The authors observed seasonal trends in 2 specialties. Practical Implications: Public health efforts are needed improve antibiotic prescribing among dental specialties.
AB - Background: Reducing inappropriate antibiotic prescriptions (Rxs) is a major quality improvement initiative in the United States. Tracking antibiotic prescribing trends is 1 method of assessing improvement in antibiotic prescribing. The purpose of this study was to assess longitudinal antibiotic prescribing practices among dental specialists. Methods: This was a retrospective ecological longitudinal trend study. The authors calculated monthly systemic antibiotic Rx counts, and rates per 100,000 beneficiaries, from a pharmacy benefits manager in the United States from 2013 through 2015. The authors calculated average annual antibiotic Rx rates (AARs) for the 3-year study period. The authors used a quasi-Poisson regression model to analyze antibiotic Rx trends. The authors quantified seasonal trends, when present, via peak-to-trough ratios (PTTRs). Results: Dental specialists prescribed 2.4 million antibiotics to the cohort of 38 million insurance beneficiaries during the 3-year study period (AAR = 2,086 Rxs per 100,000 beneficiaries). Oral and maxillofacial surgeons prescribed the most antibiotics (1,172,104 Rxs; AAR = 1,018 Rxs per 100,000 beneficiaries), followed by periodontists (527,038 Rxs; AAR = 457 Rxs per 100,000 beneficiaries), and endodontists (447,362 Rxs; AAR = 388 Rxs per 100,000 beneficiaries). Longitudinal antibiotic prescribing trends were stable among all dental specialties in the regression models (P >.05). The authors observed substantial seasonal variation in antibiotic Rxs in 2 specialties: pediatric dentistry (PTTR, 1.18; 95% confidence interval, 1.13 to 1.25) and orthodontics and dentofacial orthopedics (PTTR, 1.41; 95% confidence interval, 1.21 to 1.71), with the highest rates of antibiotic Rxs in the spring and winter. Conclusions: Antibiotic prescribing practices for dental specialists remained stable. The authors observed seasonal trends in 2 specialties. Practical Implications: Public health efforts are needed improve antibiotic prescribing among dental specialties.
KW - Dental public health
KW - antimicrobial resistance
KW - antimicrobials
KW - bacteria
KW - epidemiology
KW - infectious diseases
UR - http://www.scopus.com/inward/record.url?scp=85072200865&partnerID=8YFLogxK
U2 - 10.1016/j.adaj.2019.05.028
DO - 10.1016/j.adaj.2019.05.028
M3 - Article
C2 - 31561761
AN - SCOPUS:85072200865
VL - 150
SP - 846-853.e5
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
SN - 0002-8177
IS - 10
ER -