Antimicrobial stewardship in dental practice

Background: Antibiotic resistance is a global public health problem being responsible for increased patient morbidity and mortality and financial burden. Dental antibiotic prescribing contributes to around 10% of all antibiotic prescriptions and an estimated 80% of prescribing is deemed inappropriate. Dental antimicrobial stewardship (AMS) has an important role to play in international efforts to tackle antibiotic resistance. The aim of this review is to comment on the implementation of AMS strategies in outpatient dental practices. Types of studies reviewed: Previous studies regarding outpatient antibiotic stewardship, longitudinal studies quantifying dispensed dental antibiotic prescription use and interventional studies aimed at implementing AMS interventions in dentistry were included. Results: Several studies have trialled the use of various interventions, mostly comprising of a combination of audit, feedback, dissemination of guidelines and educational components to improve dental prescribing. Practical implications: When considering establishment of an AMS strategy, aspects should include awareness raising about the risks of unnecessary use of antibiotics. Engaging and educating the entire dental team and patients as well as collaborating with other specialised professionals are important elements. Context-specific interventions with a methodical and measured approach to is ideal