Antimicrobial Prescribing & Resistance in Dental Practice

There have been several significant changes to the guidance on the prescription of antimicrobials and colleagues may wish to review their current prescribing habits and patterns in light of this.

There is a worldwide concern over the increase in antimicrobial resistance. Dental Practitioners should understand their role in anti-microbial stewardship and work to develop an approach to this in their clinical practice.

 Practitioners should also remember that they are responsible for prescriptions they provide. The GDC may consider inappropriate prescribing as a “Fitness to Practice” issue and this is also something that the CQC is actively reviewing in its practice visits. It is possible in the future that dentists could be made accountable for negative consequences that arise as a result of their prescribing, for example in cases where Clostridium difficile infection is linked to antibiotic use. Standard principles of consent should apply to antibiotic prescriptions.

This link provides clear, simple and practical guidance on the use of antimicrobials in the management of oral and dental infections: when (and when not) to prescribe, what to prescribe (where indicated), for how long and at what dosage – or when to make an urgent referral. It was developed by the Faculty of General Dental Practice (now College of General Dentistry) and the Faculty of Dental Surgery of the Royal College of Surgeons of England. Antimicrobial prescribing in Dentistry chairside synopsis PDF

Data from the NHS BSA show Kent and Medway are outliers with particularly high levels of co-amoxiclav prescribing and low levels of Pen V prescribing. The link provides information and key messages for prescribing in Dentistry: Kent and Medway Dental Prescribing information

There is also further information in this NHS Learning Line – Learning Line Medicines September 2023 PDF

You may wish to use the audit template attached here to help review your prescribing profile and demonstrate compliance with the guidelines.  Antibiotic data collection form PDF Download

Important Information about C difficile

Clostridium Difficile Infections are serious infections of the gut commonly associated with the prescribing of antibiotics. Cases have been rising in Kent and Medway and some cases are associated with dental prescribing. Please see the following link for further information.

Important Information about C difficile pdf download

Further Resources

College of General Dentistry Antimicrobial Prescribing in Dentistry full guidelines https://cgdent.uk/antimicrobial-prescribing-in-dentistry/ (Note: you must sign in to view but you do not need to be a full member of the College to register)

Scottish Dental Clinical Effectiveness Programme Drug Prescribing For Dentistry Guidance https://www.sdcep.org.uk/published-guidance/drug-prescribing/

The Antibiotic Guardian Website https://antibioticguardian.com/

 The Anti Microbial Resistance Toolkit on elearning for Health https://www.e-lfh.org.uk/programmes/antimicrobial-resistance-and-infections/