J Am Dent Assoc. 2020 Aug;151(8):589-595. doi: 10.1016/j.esmoop.2020.04.023.
Antibiotic resistance is a global public health problem that is responsible for increased patient morbidity and mortality and financial burden. Dental antibiotic prescribing contributes to approximately 10% of all antibiotic prescriptions, and an estimated 80% of that prescribing is deemed inappropriate. Dental antimicrobial stewardship (AMS) has an important role to play in international efforts to tackle antibiotic resistance. The aim of the authors was to comment on the implementation of AMS strategies in outpatient dental practices.
The authors included previous studies regarding outpatient antibiotic stewardship, longitudinal studies quantifying dispensed dental antibiotic prescription use, and interventional studies aimed at implementing AMS interventions in dentistry.
Researchers in several studies conducted trials regarding the use of various interventions, mostly comprising a combination of audit, feedback, dissemination of guidelines, and educational components to improve dental prescribing.
In regard to the establishment of an AMS strategy, aspects to be considered should include raising awareness about the risks of unnecessary use of antibiotics. Engaging and educating the entire dental team and patients, as well as collaborating with other specialized professionals, are important elements. Context-specific interventions with a methodical and measured approach are ideal.
抗生素耐药性是一个全球性的公共卫生问题，它导致患者发病率和死亡率上升以及经济负担加重。牙科抗生素的使用约占所有抗生素处方的 10%，据估计其中 80%的处方被认为是不适当的。牙科抗菌药物管理（AMS）在应对抗生素耐药性的国际努力中发挥着重要作用。作者的目的是对门诊牙科实践中实施 AMS 策略进行评论。
作者纳入了关于门诊抗生素管理的先前研究、定量评估配给的牙科抗生素处方使用情况的纵向研究，以及旨在在牙科领域实施 AMS 干预的干预性研究。
一些研究的研究人员针对各种干预措施进行了试验，这些干预措施大多包括审核、反馈、指南传播和教育组成部分的组合，以改善牙科处方。
在制定 AMS 策略方面，应考虑提高对抗生素不必要使用的风险的认识。让整个牙科团队和患者参与并接受教育，以及与其他专业人员合作，是重要的组成部分。具有针对性、系统性和可衡量性的干预措施是理想的。
