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. 2023 Nov;44(11):1725-1730.
doi: 10.1017/ice.2023.151. Epub 2023 Aug 22.

Changes in antibiotic prescribing by dentists in the United States, 2012-2019

Swetha Ramanathan  1 , Connie H Yan  2 , Colin Hubbard  3 , Gregory S Calip  2 , Lisa K Sharp  2 , Charlesnika T Evans  4   5 , Susan Rowan  6 , Jessina C McGregor  7 , Alan E Gross  2 , Ronald C Hershow  1 , Katie J Suda  8   9
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Changes in antibiotic prescribing by dentists in the United States, 2012-2019

Swetha Ramanathan et al. Infect Control Hosp Epidemiol. 2023 Nov.

Abstract

Objectives: Dentists prescribe 10% of all outpatient antibiotics in the United States and are the top specialty prescriber. Data on current antibiotic prescribing trends are scarce. Therefore, we evaluated trends in antibiotic prescribing rates by dentists, and we further assessed whether these trends differed by agent, specialty, and by patient characteristics.

Design: Retrospective study of dental antibiotic prescribing included data from the IQVIA Longitudinal Prescription Data set from January 1, 2012 to December 31, 2019.

Methods: The change in the dentist prescribing rate and mean days' supply were evaluated using linear regression models.

Results: Dentists wrote >216 million antibiotic prescriptions between 2012 and 2019. The annual dental antibiotic prescribing rate remained steady over time (P = .5915). However, the dental prescribing rate (antibiotic prescriptions per 1,000 dentists) increased in the Northeast (by 1,313 antibiotics per 1,000 dentists per year), among oral and maxillofacial surgeons (n = 13,054), prosthodontists (n = 2,381), endodontists (n = 2,255), periodontists (n = 1,961), and for amoxicillin (n = 2,562; P < .04 for all). The mean days' supply significantly decreased over the study period by 0.023 days per 1,000 dentists per year (P < .001).

Conclusions: From 2012 to 2019, dental prescribing rates for antibiotics remained unchanged, despite decreases in antibiotic prescribing nationally and changes in guidelines during the study period. However, mean days' supply decreased over time. Dental specialties, such as oral and maxillofacial surgeons, had the highest prescribing rate with increases over time. Antibiotic stewardship efforts to improve unnecessary prescribing by dentists and targeting dental specialists may decrease overall antibiotic prescribing rates by dentists.

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Conflict of interest statement

Collin Hubbard reports receiving funding from grants from Pfizer, outside the submitted work. Gregory S. Calip reports current employment with Flatiron Health (an independent subsidiary of the Roche group), stock ownership in Roche, and research funding from Pfizer (awarded to the University of Illinois at Chicago). Charlesnika T. Evans reports grants from the Veterans’ Administration and the National Institutes of Health and ownership in Canna Ventures and CESAM, LLC. Katie J. Suda reports grants from the Veterans’ Health Administration, the National Institute of Drug Abuse, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Agency for Healthcare Research and Quality, outside the submitted work. All other authors report no conflicts of interest relevant to this article.

Figures

Figure 1.
Figure 1.
Changes in yearly dentist prescribing rate by dental specialties from 2012 to 2019. aPrescribing rate is per 1,000 dentists per year. bIncludes oral tablets or capsules and liquid antibiotics in both adults and children. cPrescribing rates increased significantly for endodontists, periodontists, prosthodontists, and oral and maxillofacial surgeons, but decreased significantly for orthodontists.
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