Cirkel Lisa Lotta, Herrmann Jens Martin, Ringel Claudia, Wöstmann Bernd, Kostev Karel
Department of Cariology, Periodontology, and Endodontology, Dental Clinic, Justus Liebig University, 35392 Giessen, Germany.
Real World Solutions, IQVIA, 04229 Leipzig, Germany.
Antibiotics (Basel). 2025 Jul 3;14(7):676. doi: 10.3390/antibiotics14070676.
ABs are widely used in dental practice in the treatment of odontogenic infections and as systemic prophylaxis in high-risk patients. However, AB overuse contributes to antimicrobial resistance (AMR), which is a major global concern. This study examined dental AB prescribing trends in Germany in 2024, focusing on the share of overall AB prescriptions, patient demographics, and commonly used agents. This retrospective cross-sectional study used data from the IQVIA Longitudinal Prescription Database (LRx), covering approximately 80% of prescriptions reimbursed by statutory health insurance funds in Germany. Patients with at least one AB prescription (ATC code: J01) issued by a dentist in 2024 were analyzed. Descriptive statistics covered age, sex, and prescribed substances. In 2024, German dentists prescribed ABs to 2,325,500 patients, accounting for 13.9% of all patients in the database who received AB prescriptions. Dentists were the second-largest group of AB prescribers, surpassed only by general physicians. Amoxicillin (54.2%) was most frequently prescribed, followed by amoxicillin with clavulanic acid (24.5%) and clindamycin (21.0%). Dental patients receiving AB prescriptions were older (mean age: 49.8 years) than the general antibiotic patient population (44.7 years). Interestingly, dental AB prescriptions increased during the COVID-19 pandemic, in contrast to the sharp overall decline in AB prescriptions. Between 2015 and 2019, the proportion of dental antibiotic prescriptions showed a moderate upward tendency, followed by a marked increase during the COVID-19 pandemic and a subsequent decline. In contrast, the number of patients receiving antibiotic prescriptions from other medical disciplines decreased over the same period. One particularly notable finding was the extended use of clindamycin, a reserve AB with known side effects and resistance risks, in dentistry. Dentists are responsible for a significant share of AB prescriptions in Germany. The rise in dental AB prescriptions, particularly the frequent prescription of clindamycin, underscores the need for interventions such as updated clinical guidelines and awareness campaigns concerning AB-related risks and their mitigation directed at dentists. These could focus on microbial culture and sensitivity testing and patient adherence education and control for targeted AB interventions. Emphasizing preventive and alternative anti-infective treatment strategies in dentistry may also help to contain AMR.
抗生素在牙科实践中广泛用于治疗牙源性感染，并作为高危患者的全身预防用药。然而，抗生素的过度使用会导致抗菌药物耐药性（AMR），这是一个全球主要关注的问题。本研究调查了2024年德国牙科抗生素的处方趋势，重点关注抗生素处方总量的占比、患者人口统计学特征以及常用药物。这项回顾性横断面研究使用了IQVIA纵向处方数据库（LRx）的数据，该数据库涵盖了德国法定健康保险基金报销的约80%的处方。对2024年至少有一张由牙医开具的抗生素处方（ATC代码：J01）的患者进行了分析。描述性统计包括年龄、性别和所开药物。2024年，德国牙医为2325500名患者开具了抗生素处方，占数据库中所有接受抗生素处方患者的13.9%。牙医是第二大抗生素处方开具群体，仅次于全科医生。阿莫西林（54.2%）的处方最为频繁，其次是阿莫西林克拉维酸（24.5%）和克林霉素（21.0%）。接受抗生素处方的牙科患者比一般抗生素患者群体年龄更大（平均年龄：49.8岁）（44.7岁）。有趣的是，与抗生素处方总量的急剧下降形成对比的是，在新冠疫情期间牙科抗生素处方有所增加。2015年至2019年期间，牙科抗生素处方比例呈适度上升趋势，随后在新冠疫情期间显著增加，随后又有所下降。相比之下，同期接受其他医学学科抗生素处方的患者数量减少。一个特别值得注意的发现是，克林霉素这种具有已知副作用和耐药风险的储备抗生素在牙科中的使用有所增加。在德国，牙医开具的抗生素处方占很大比例。牙科抗生素处方的增加，尤其是克林霉素的频繁处方，凸显了采取干预措施的必要性，如更新临床指南以及针对牙医开展有关抗生素相关风险及其缓解措施的宣传活动。这些措施可以侧重于微生物培养和药敏试验以及患者依从性教育，并对针对性的抗生素干预进行控制。强调牙科中的预防性和替代性抗感染治疗策略也可能有助于控制抗菌药物耐药性。
