Prim Dent J. 2014 Nov;3(4):24-9. doi: 10.1308/205016814813877270.
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) 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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