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 - Funding Information:
Disclosures. Drs. Munshi and Henderson are employees of Express Scripts Holding Company (ESHC) and have received ESHC stock and stock options as part of employee compensation. Dr. Fraser has grant funding from the Centers for Disease Control and Prevention, Doris Duke Charitable Foundation, Foundation for Barnes-Jewish Hospital, and National Institutes of Health, and her spouse is senior vice president and chief medical officer at ESHC. None of the other authors reported any disclosures.This study was funded by grant U54CK000482 (M.J.D., Q.F., K.W., V.J.F.) from the Centers for Disease Control and Prevention. Research reported in this publication was supported by award KL2TR002346 from the National Center for Advancing Translational Sciences, National Institutes of Health.
Publisher Copyright:
© 2019 American Dental Association
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 -