Category: Antimicrobial Stewardship: Trends in Antimicrobial Prescribing

Poster Session: Antimicrobial Stewardship: Trends in Antimicrobial Prescribing

218 - Changes in Dental Antibiotic Prescribing in the United States, 2012-2017

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Presenting Author(s)

Swetha Ramanathan

PhD Candidate
University of Illinois at Chicago
Chicago, Illinois
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

CY

Connie H. Yan

Pharmacist
University of Illinois at Chicago
Chicago, Illinois
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CH

Colin Hubbard

Biostatistician
University of Illinois Chicago
Chicago, Illinois
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GC

Gregory Calip

Assistant Professor
University of Illinois
Chicago, IL
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LS

Lisa K. Sharp

Professor and Associate Head
University of Illinois Chicago
Chicago, Illinois
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SR

Susan A. Rowan

Clinical Associate Professor
University of Illinois
Chicago, IL
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Jessina C. McGregor

Professor
Oregon State University
Portland, OR
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AG

Alan E. Gross

Clinical Assistant Professor
University of Illinois
Chicago, IL
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AC

Allen Campbell

Director
IQVIA
Plymouth, Pennsylvania
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Charlesnika T. Evans

Associate Professor and Research Health Scientist
Northwestern University and VA
Hines, Illinois
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RH

Ronald Hershow

Associate Professor of Epidemiology
University of Illinois
Chicago, IL
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Katie J. Suda

Research Health Scientist and Professor
Center for Health Equity Research and Promotion and University of Pittsburgh
Pittsburgh, Pennsylvania
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Data suggest dental antibiotic prescribing is increasing with relatively less documented about prescribing trends in adults and children. Therefore, the aim was to evaluate trends in antibiotic prescribing by US dentists from 2012-2017.

Methods: This was a cross-sectional study of US dental prescribing using IQVIA Longitudinal Prescription Data from 2012 to 2017. Prescribing rates (prescriptions [Rx] per 100,000 dentists), mean days’ supply, and mean quantity dispensed were calculated monthly across eight oral antibiotic groups: amoxicillin, clindamycin, cephalexin, azithromycin, penicillin, doxycycline, fluoroquinolone, and other antibiotics. Descriptive frequencies and multiple linear regressions were performed to obtain trends overall and stratified by adults (≥ 18) and children (< 18).

Results: 220, 325 dentists prescribed 135 million Rx (94.0% in adults). 61.0% were amoxicillin, 14.4% clindamycin, 11.7% penicillin, 4.4% azithromycin, 4.3% cephalexin, 2.0% other antibiotics, 1.4% doxycycline, and 0.7% fluoroquinolones. Prescribing increased by 33 Rx/100,000 dentists (p< 0.0001) each month for all antibiotics. Amoxicillin (p< 0.0001) and clindamycin (p=0.02) prescribing rate increased by 73 and 5 Rx/100,000 dentists, respectively. Prescribing decreased by 8, 12, and 2 Rx/100,000 dentists for cephalexin (p< 0.0001), doxycycline (p< 0.0001), and fluoroquinolones (p=0.008), respectively. Mean days’ supply increased for amoxicillin, penicillin, and clindamycin (p< 0.0001), and decreased for cephalexin (p< 0.0001).Mean quantity dispensed decreased (p< 0.0001) for all groups except azithromycin and doxycycline. Among adults, cephalexin prescribing rates (7 Rx/100,000 dentist; p< 0.0001) and other antibiotics days’ supply (p< 0.0001) decreased. Among children, azithromycin prescribing rates (1 Rx/100,000 dentists, p=0.02), and fluoroquinolone and other antibiotics days’ supply (p< 0.0001) decreased.

Conclusion: These findings support dental antibiotic prescribing is increasing, specifically for amoxicillin and clindamycin. Further, trends differed between adults and children. Understanding what is driving these trends is important to target dental antibiotic stewardship efforts.