An Audit of Antimicrobial Prescribing in an Acute Dental Care Department

Abstract

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)1 and Scottish Dental Clinical Effectiveness2 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.