Goff Debra A, Mangino Julie E, Trolli Elizabeth, Scheetz Richard, Goff Douglas
Department of Pharmacy, The Ohio State University Wexner Medical Center, The Ohio State University College of Pharmacy, Columbus, Ohio, USA.
Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Open Forum Infect Dis. 2022 Jul 25;9(8):ofac361. doi: 10.1093/ofid/ofac361. eCollection 2022 Aug.
Private practice dentists represent 72% of United States dentists. We conducted a prospective cohort study of private practice dentists comparing antibiotic use before and after dental antibiotic stewardship education by infectious diseases (ID) antibiotic stewardship experts.
Study phases were as follows: phase 1 (preeducation), 3 months of retrospective antibiotic data and a presurvey assessed baseline antibiotic knowledge; phase 2 (education), dentists attended 3 evening Zoom sessions; phase 3, (posteducation/interventions), 3 months of prospective audits with weekly feedback; phase 4, postsurvey and recommendations to reach more dentists.
Fifteen dentists participated. Ten had practiced >20 years. Presurvey, 14 were unfamiliar with dental stewardship. The number of antibiotic prescriptions pre/post decreased from 2124 to 1816 ( < .00001), whereas procedures increased from 8526 to 9063. Overall, appropriate use (prophylaxis and treatment) increased from 19% pre to 87.9% post ( < .0001). Appropriate prophylaxis was 46.6% pre and 76.7% post ( < .0001). Joint implant prophylaxis decreased from 164 pre to 78 post ( < .0001). Appropriate treatment antibiotics pre/post improved 5-fold from 15% to 90.2% ( = .0001). Antibiotic duration pre/post decreased from 7.7 days (standard deviation [SD], 2.2 days) to 5.1 days (SD, 1.6 days) ( < .0001). Clindamycin use decreased 90% from 183 pre to 18 post ( < .0001). Postsurvey responses recommended making antibiotic stewardship a required annual continuing education. Study participants invited ID antibiotic stewardship experts to teach an additional 2125 dentists via dental study clubs.
After learning dental antibiotic stewardship from ID antibiotic stewardship experts, dentists rapidly optimized antibiotic prescribing. Private practice dental study clubs are expanding dental antibiotic stewardship training to additional dentists, hygienists, and patients across the United States.
私人执业牙医占美国牙医总数的72%。我们对私人执业牙医进行了一项前瞻性队列研究，比较了传染病（ID）抗生素管理专家开展牙科抗生素管理教育前后的抗生素使用情况。
研究阶段如下：第1阶段（教育前），回顾3个月的抗生素数据并进行预调查，以评估抗生素知识基线；第2阶段（教育阶段），牙医参加3次晚间Zoom会议；第3阶段（教育后/干预阶段），进行3个月的前瞻性审核并每周提供反馈；第4阶段，进行后调查并提出针对更多牙医的建议。
15名牙医参与了研究。其中10人执业超过20年。预调查时，14人不熟悉牙科管理。抗生素处方数量在教育前后从2124降至1816（P<0.00001），而诊疗程序从8526增加到9063。总体而言，合理使用（预防和治疗）从教育前的19%增至教育后的87.9%（P<0.0001）。合理预防从教育前的46.6%增至教育后的
