This study highlights the significant role of German dentists in antibiotic prescriptions and reveals changes in prescription behavior over time. It particularly notes the increased proportion of dental antibiotic prescriptions during the COVID-19 pandemic and the persistently high usage of clindamycin as a reserve antibiotic. The findings emphasize the urgency of updating clinical guidelines and enhancing dentists' awareness of antibiotic resistance.
Literature Overview
This study, titled 'Antibiotic Prescription in Dentistry: Trends, Patient Demographics, and Drug Preferences in Germany' published in the journal Antibiotics, reviews the antibiotic prescription practices of German dentists in 2024, including prescription proportions, patient age and gender distribution, and commonly used drug categories. The research compares prescription trends between 2015 and 2024, identifying shifts in dentists' contribution to overall antibiotic prescriptions. Notably, while global antibiotic use declined, dental prescriptions showed growth in specific years, warranting further investigation.
Background Knowledge
Antibiotics are widely used in medicine, particularly for treating odontogenic infections and prophylaxis in high-risk patients. However, antibiotic misuse accelerates antimicrobial resistance (AMR), a global health crisis. Recent studies show dentists' contribution to total antibiotic prescriptions has increased, especially during the 2020–2021 pandemic, when overall prescriptions decreased but dental prescriptions rose significantly. Additionally, clindamycin remains heavily used in dentistry despite its resistance risks and adverse effects. German dentists still rely on outdated 2016 clinical guidelines, while international counterparts like the US have updated recommendations for safer first-line therapies. This research provides updated prescription trends and drug utilization patterns based on a large-scale prescription database, offering data support for developing rational clinical guidelines and regulatory strategies.
Research Methods and Experiments
This retrospective cross-sectional study utilized data from the IQVIA Longitudinal Prescription Database (LRx), covering prescription information for approximately 80% of German patients with statutory health insurance. It included patients who received at least one antibiotic prescription (ATC code: J01) from dentists in 2024, with descriptive statistical analyses conducted on drug categories, patient age, and gender distribution. Prescription trends from 2015–2024 were compared, and differences between dental and other medical specialties were analyzed.
Key Conclusions and Perspectives
Research Significance and Prospects
The study underscores dentists' potential impact on antibiotic use and AMR spread, recommending guideline updates, promotion of microbial culture and sensitivity testing, and patient adherence education. Future research should analyze trends in specific antibiotics (e.g., amoxicillin vs. clindamycin) and assess prescription changes following guideline revisions. Implementing alternative infection-control strategies and strengthening AMR awareness among dentists could reduce unnecessary prescriptions and curb resistance. These findings also provide comparative insights for global dental prescription practices and inform antimicrobial stewardship programs.
Conclusion
This study systematically analyzed German dentists' antibiotic prescription patterns in 2024 and tracked trends from 2015–2024. Dentists represent a critical prescription source in Germany, particularly for middle-aged and elderly patients. Despite global reductions in antibiotic use, dental prescriptions increased during 2020–2021, potentially due to pandemic-related access restrictions and heightened infection awareness. The research highlights clindamycin's high usage rate, a drug with significant resistance and adverse effect risks, underscoring the need for standardized prescription protocols and updated guidelines. Future efforts should focus on precise microbial diagnostics, optimized patient adherence education, and alternative prophylactic strategies to mitigate dental AMR. Additionally, the study offers comparative references for dental prescription practices in other regions, supporting evidence-based antimicrobial management.
