Teoh L, Stewart K, Marino R J, McCullough M J
Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia.
Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia.
Aust Dent J. 2018 May 13. doi: 10.1111/adj.12622.
Literature has shown dentists tend to overprescribe antibiotics and do not always prescribe in accordance with recommended guidelines. Unnecessary prescribing is one major factor that contributes to the development of antibiotic resistance. The aim of the present study was to assess the antibacterial prescribing patterns of dentists in Australia from 2013 to 2016.
Data on dental antibacterial prescriptions dispensed under the Pharmaceutical Benefits Scheme (PBS) from 2013 to 2016 was accessed and prescribing trends analysed. The prescribing rates were standardized to the dose and population.
There was a slight decrease in the dispensed use of most antibacterials from 2013 to 2016, but there was a significant increase in the dispensed use of amoxicillin/clavulanic acid of 11.2%. Amoxicillin was the most commonly dispensed antibiotic, accounting for approximately 65% of all antibacterials from 2013 to 2016, while phenoxymethylpenicillin accounted for only 1.4% of prescriptions in 2016. There were low but significant quantities of dispensed antibiotic prescriptions that do not fit with current guidelines.
The data suggest that dentists in Australia are prescribing some antibiotics inappropriately and there is a preference for moderate- to broad-spectrum agents. The current PBS dental schedule is inconsistent with prescribing guidelines and may contribute to inappropriate prescribing.
文献表明，牙医往往过度开具抗生素处方，且并非总是按照推荐指南进行处方。不必要的处方是导致抗生素耐药性产生的一个主要因素。本研究的目的是评估2013年至2016年澳大利亚牙医的抗菌药物处方模式。
获取了2013年至2016年根据药品福利计划（PBS）发放的牙科抗菌药物处方数据，并分析了处方趋势。将处方率按照剂量和人口进行标准化。
从2013年到2016年，大多数抗菌药物的发放使用量略有下降，但阿莫西林/克拉维酸的发放使用量显著增加了11.2%。阿莫西林是最常发放的抗生素，在2013年至2016年期间约占所有抗菌药物的65%，而苯氧甲基青霉素在2016年的处方中仅占1.4%。有少量但数量可观的抗生素处方不符合现行指南。
数据表明，澳大利亚的牙医在不恰当地开具一些抗生素处方，并且倾向于使用中广谱药物。当前的PBS牙科用药目录与处方指南不一致，可能导致不恰当的处方。
