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An Audit of Antimicrobial Prescribing in an Acute Dental Care Department

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Introduction: Antimicrobial resistance is a growing problem that is likely to have a major negative impact on healthcare in the future. Dentists have a key role in ensuring that antimicrobials are prescribed correctly to reduce the emergence of resistant strains.

Objective: To audit how appropriately antimicrobials were prescribed in the oral surgery acute dental department of Guy's Hospital in London, when compared to the standards set within the Faculty of General Dental Practice (UK) and Scottish Dental Clinical Effectiveness guidelines on antimicrobial prescribing in dentistry.

Target: 100% compliance.

Method: A prospective audit consisting of two cycles (each including 60 patients) was carried out. Between each cycle, there was a two-month intervention period, which included extensive training and education of staff and students.

Results: Cycle 1 showed that only 30% of prescriptions were appropriate and only 62% of practitioners were recording a diagnosis. After two months of intervention, cycle 2 was carried out; this showed a significant improvement, with 80% of prescriptions being appropriate and 100% of practitioners recording a diagnosis. The majority of inappropriate prescriptions in both cycles were for acute pulpitis without evidence of systemic involvement.

Conclusion: This audit has shown that clinical practice for antimicrobial prescribing did not follow the published guidelines. Following targeted interventions, a substantial improvement was made in the prescribing pattern. The target of 100% has not been reached, necessitating further intervention.
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Keywords: ANTIMICROBIAL RESISTANCE; AUDIT; AUDIT CYCLE; EDUCATION; INTERVENTION

Document Type: Research Article

Affiliations: Bridge Street Dental Practice, Oxford, UK

Publication date: 2014-11-01

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  • Primary Dental Journal (PDJ) is the peer reviewed journal of the Faculty of General Dental Practice (UK). The professional development journal is aimed at the whole primary care team. Each issue focuses on a key topic in primary care dentistry and offers a combination of research, clinical best practice papers and scenario articles which allow the whole dental team to work together to improve standards of patient care.
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