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2018年至2022年美国普通牙医的门诊抗生素处方情况。

Outpatient antibiotic prescribing by general dentists in the United States from 2018 through 2022.

作者信息

Huynh Cam-Van T, Gouin Katryna A, Hicks Lauri A, Kabbani Sarah, Neuburger Michele, McDonald Emily

出版信息

J Am Dent Assoc. 2025 May;156(5):382-389.e2. doi: 10.1016/j.adaj.2024.12.003. Epub 2025 Mar 6.

Abstract

BACKGROUND

Dentists play a role in combatting antimicrobial resistance. This analysis characterizes antibiotic prescribing changes by dentists after the American Dental Association's dental infection treatment guideline was released in 2019.

METHODS

The Xponent (IQVIA) database was used to extract antibiotic prescriptions dispensed from 2018 through 2022. General dentist prescriptions were compared with total outpatient oral antibiotics and summarized by patient and provider characteristics. Census denominators were used to calculate prescribing rates per 1,000 people.

RESULTS

Dentists prescribed 24.65 million antibiotics in 2018 compared with 25.17 million in 2022, resulting in 75.5 prescriptions per 1,000 people for both years. From 2018 through 2022, dentists prescribed 9.8% through 12.1% of all outpatient antibiotics. Females, patients 65 years and older, and patients in the Northeast received the most antibiotic prescriptions.

CONCLUSIONS

Prescribing by general dentists remained stable from 2018 through 2022 despite guideline recommendations to limit antibiotic use for dental infections. Variation by patient and provider characteristics may represent unnecessary antibiotic use.

PRACTICAL IMPLICATIONS

Antibiotic stewardship is needed to optimize prescribing in the dental care setting. The Centers for Disease Control and Prevention's Core Elements of Outpatient Antibiotic Stewardship framework can be adapted for dental stewardship implementation.

摘要

背景

牙医在对抗抗菌药物耐药性方面发挥着作用。本分析描述了美国牙科协会2019年发布牙科感染治疗指南后牙医抗生素处方的变化情况。

方法

使用Xponent(IQVIA)数据库提取2018年至2022年期间分发的抗生素处方。将普通牙医的处方与门诊口服抗生素总量进行比较,并按患者和医疗服务提供者的特征进行汇总。使用人口普查分母计算每千人的处方率。

结果

2018年牙医开出了2465万份抗生素处方,2022年为2517万份,两年的每千人处方数均为75.5份。从2018年到2022年,牙医开出的抗生素占所有门诊抗生素的9.8%至12.1%。女性、65岁及以上的患者以及东北部的患者接受的抗生素处方最多。

结论

尽管有指南建议限制牙科感染的抗生素使用,但2018年至2022年期间普通牙医的处方量保持稳定。患者和医疗服务提供者特征的差异可能代表了不必要的抗生素使用。

实际意义

需要进行抗生素管理以优化牙科护理环境中的处方。疾病控制与预防中心门诊抗生素管理框架的核心要素可适用于牙科管理的实施。

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