National dental and medical organisations have come together again to support the World Health Organisation’s Antimicrobial Awareness Week, which runs from 18-24 November.
The Association of Clinical Oral Microbiologists and College of General Dentistry, supported by the Association of Dental Hospitals, British Dental Association, Healthcare Improvement Scotland, British Association of Oral Surgery, British Society for Antimicrobial Chemotherapy, Faculty of Dental Surgery of the Royal College of Surgeons of England, Faculty of Dental Surgery of the Royal College of Surgeons of Edinburgh, and the Faculty of Dental Surgery of the Royal College of Physicians and Surgeons of Glasgow, are reminding patients that “antibiotics do not cure toothache”, and encouraging the dental team to adhere to best practice and only prescribe antibiotics as an adjunct to definitive clinical management of the cause when indicated according to national guidelines.
Prudent prescribing of antimicrobials can slow down the development of antimicrobial resistance, and all healthcare prescribers play a vital role. The dental profession has shown its commitment to addressing antimicrobial resistance by significantly reducing the use of antibiotics over the last decade, both in dental practice and a hospital setting. Dental hospitals in the UK and Ireland reduced antibiotic prescriptions by 22 per cent and 30 per cent for therapeutic and prophylactic indications respectively between 2018 and 2020 (prior to the Covid-19 pandemic).
It has been reported that Covid-19 had a negative effect on the profession’s endeavours in improving antibiotic prescribing patterns. The organisations therefore encourage dental teams in both general practice and hospital settings to re-start auditing their practice of antibiotic prescribing against the recently updated national guidelines, as this will help to reduce the use of antimicrobials and improve patient outcomes.
The successful management of acute dental infections requires accurate diagnosis and definitive treatment, and patients who have prompt access to emergency dental services have a much-reduced risk of developing life-threatening sepsis. Dental teams are encouraged to use the following resources to update their knowledge on the latest national recommendations on the use of antimicrobial agents in dentistry, and to audit their practice:
- Guidelines for antimicrobial prescribing in dentistry are available at https://cgdent.uk/standards-guidance/ and https://bnf.nice.org.uk
- Guidance for antimicrobials in dentistry in Scotland are available at https://www.sdcep.org.uk/published-guidance/drug-prescribing/ and https://www.sapg.scot/media/5473/statement-on-pen-v-in-dental-infections.pdf
- Antimicrobial prescribing audit tools are available at https://cgdent.uk/standards-guidance/ and https://heiw.nhs.wales/education-and-training/dental/quality-improvement/national-audit-projects/antimicrobial-prescribing/
Other resources, including the Dental Antimicrobial Stewardship Toolkit, are available via https://cgdent.uk/standards-guidance/ and https://bda.org/amr