Dental antibiotic use in British Columbia from 1996 through 2023: Are we backsliding?

J Am Dent Assoc. 2024 Nov 18:S0002-8177(24)00550-6. doi: 10.1016/j.adaj.2024.10.001. Online ahead of print.

Abstract

Background: Dentists in the United States and Canada have higher rates of prescribing broad-spectrum spectrum antibiotics than dentists in some other Western countries. The authors provide an overview of dental antibiotic prescribing trends from British Columbia, Canada.

Methods: The data include all prescriptions filed from pharmacies in British Columbia from 1996 through 2023. Dental antibiotic prescribing trends were explored visually and stratified according to patient-related characteristics, type of health service area, type of antibiotic, duration of therapy, and dentist's experience. Interrupted time series regression analysis was conducted to investigate the impact of the COVID-19 pandemic on dental antibiotic prescribing.

Results: Dentistry accounted for an increasing proportion of overall antibiotic consumption in British Columbia. Dental prescriptions increased to a peak rate during the COVID-19 pandemic and remained elevated into 2023. The median duration of prescription converged toward a 7-day supply during the study period.

Conclusions: The authors documented how a decreasing trend in dental antibiotic prescribing prepandemic has been interrupted by means of continuously high rates after that event.

Practical implications: Renewed efforts to ensure appropriateness of dental antibiotic prescribing are needed.

Keywords: Antibiotic prescribing; COVID-19; antibiotic stewardship; antibiotics; lockdown impact; patient safety; perioperative prophylaxis.