Rise in Dental Antibiotic Prescriptions

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Dramatic rise in antibiotics prescribed by dentists during first lockdown

FDI World Dental Federation (FDI) has released a new White Paper on antibiotic resistance to mark World Antimicrobial Awareness Week. According to a new study published last week (13th November) one of the unintended consequences of the COVID-19 lockdowns in England earlier this year has been a 25% increase in the prescription of antibiotics by dentists.

Prescription rates were the highest in London, with an increase of 60% for the same period and the lowest increases, less than 10%, were in the South-West of England. Antibiotic resistance (ABR) is a global problem that poses a significant threat to health and wealth, due to prolonged illnesses, longer hospital stays and increased mortality.

The World Health Organisation (WHO) has highlighted the urgency of tackling ABR by including it in the five platforms to global health and well-being. ABR is a problem that affects everyone and needs tackling urgently. If ABR continues to increase, it is estimated that infections resistant to drugs will be the number one cause of death globally within the next 30 years.

The WHO’s annual World Antimicrobial Awareness Week is held from November 18–24. A spokesperson said “Antibiotics do not cure toothache. Most dental infections are amenable to treatment by a dental procedure to remove the source of the infection without the need for antibiotics.

“In normal times, antibiotic-only treatment plans are rarely appropriate. Unnecessary use of antibiotics drives the development and spread of resistant infections.”

“Antibiotics are life-saving drugs; when people really need them, they really need to work,” said Dr Wendy Thompson, author of the study, a clinical academic in primary dental care at the University of Manchester, and member of the FDI ABR Working Group.

“Infections that are resistant to antibiotics pose a serious risk to patient safety—which is why the large rise in dental antibiotic prescribing (over 25% in the three months of April to June) is a huge concern. After years of a downward trend, restricted access to dental care due to COVID-19 drove this sudden increase. We must guard against it happening again when the UK finds itself in another lockdown environment.

“We live in especially challenging times. Patients waiting for access to care often receive more antibiotics than those patients who receive the right treatment immediately. As dental care provision returns to a ‘new normal’ in the COVID-19 era, it is important to ensure access to high-quality, urgent dental care and to optimise the use of antibiotics.”

‘Slow-motion pandemic’

FDI released its White Paper to acknowledge the urgency of the situation and the essential role of the dental team in reducing antibiotic resistance, which is supported by an online library of resources and accompanied by a massive open online course (MOOC).

The paper is an important step forward in acknowledging that dentists around the world must be recognized for their role in preventing and treating dental infections and empowered to optimize their antibiotic prescribing.

Dr Gerhard K. Seeberger, president of FDI, added: “We are staring down a slow-motion pandemic and urgent collective action is needed to slow it down. Moving forward, the dental profession has a clear responsibility to engage, commit and contribute to global, national and local efforts to tackle antibiotic resistance.”