Use and Misuse of Antibiotics in Dentistry: A Systematic Review

Objectives: The aim of this systematic review was to investigate the antibiotic prescription habits of dentists. Specifically, we explored the types of antibiotics prescribed, their duration, dose and frequency, the reasons for their prescription, if their distribution is in accordance with evidence-based guidelines and the changeability of these prescribing practices.
Methods: A systematic review of published literature was conducted by searching EMBASE, PubMed, Ovid MEDLINE, Scopus, and Google Scholar. Key search terms included Dentist, Antibiotic, Antimicrobial, Antibacterial, Prophylaxis, Prescription, Pattern, Habits, Knowledge, and Practice. Studies were qualitatively assessed using a modified version of the Center for Evidence-Based Medicine’s (CEBM) checklist for the critical appraisal of surveys.
Results: We identified 1,496 studies but only 99 studies were considered eligible for review. The majority of studies were either cross-sectional surveys or prescription audits from various geographic jurisdictions. Most studies did not assess statistical significance. On balance, the literature suggests that dentists are over-prescribing both prophylactic and therapeutic antibiotics. Possible reasons for this include: the increased use of prophylaxis with surgical dental procedures, slow adoption of new guidelines, external pressures, a lack of knowledge, and the presence of clinical barriers in the dental office.
Conclusions: Public health and professionally-driven initiatives should be implemented to improve the antibiotic prescription practices of dentists in order to limit the overuse of antibiotics in dentistry.