Document Detail


The impact of clinical audit on antibiotic prescribing in general dental practice.
MedLine Citation:
PMID:  17128233     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To reduce the number of antibiotics inappropriately prescribed by general dental practitioners, and to increase overall prescription accuracy. DESIGN: A prospective clinical audit carried out between September and March of 2002-3 and 2003-4. SETTING: General dental practices in Eastern England. SUBJECTS AND METHODS: The pre-audit antibiotic prescribing practices of 212 general dental practitioners were recorded over an initial six week period. On each occasion this included which antibiotic had been chosen, together with its dose, frequency and duration, as well as the clinical condition and reason for which the prescription had been raised. When related to prophylaxis, the patient's medical history was also noted. Following education on contemporary prescribing guidelines, presentations which illustrated the practitioners' previous errors, and the agreement of standards to be achieved, the process was repeated for another six weeks, and the results compared. RESULTS: In the pre-audit period, 2,951 antibiotic prescriptions were issued, and during the audit this was reduced by 43.6% to 1,665. The majority were for therapeutic reasons, with only 10.5% and 13.6% for medical prophylaxis during the pre-audit and audit periods respectively. Over both periods, amoxicillin and metronidazole were the two most commonly prescribed antimicrobials (63.4% and 21.2% respectively). In the pre-audit period, only 43% of all prescriptions were error free in dose, frequency, and/or duration of use, but this rose significantly to 78% during the audit. Equally, using contemporary published guidelines, out of all the prescriptions made in the pre-audit period, only 29.2% were deemed to be justified, as compared to 48.5% during the audit. CONCLUSIONS: Clinical audit, in conjunction with education, and prescribing guidelines can favourably change antibiotic prescribing patterns among general dental practitioners.
Authors:
R A C Chate; S White; L R O Hale; A P Howat; J Bottomley; J Barnet-Lamb; J Lindsay; T I Davies; J M Heath
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  British dental journal     Volume:  201     ISSN:  0007-0610     ISO Abbreviation:  Br Dent J     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-27     Completed Date:  2007-05-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513219     Medline TA:  Br Dent J     Country:  England    
Other Details:
Languages:  eng     Pagination:  635-41     Citation Subset:  D; IM    
Affiliation:
Orthodontic Department, Essex County Hospital, Lexden Road, Colchester C03 3NB. racchate@rcsed.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents*
Dental Audit / methods*
Drug Utilization / statistics & numerical data*
England
Humans
Prospective Studies
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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