Prescribing antimicrobials effectively in Dentistry; Resources to support the role of the dentist in antimicrobial stewardship

Abstract

Background The discovery of antibiotics revolutionised modern medicine and extended the average human lifespan by 23 years.1 Antimicrobial resistance threatens to reverse the progress that has been made. In 2019, there were 4.95 million deaths globally associated with drug-resistant bacterial infections.2 That figure may rise to as many as 50 million by 2050, making this an unprecedented global public health problem.3 The threat of a post-antibiotic era has prompted the publication of Ireland’s One Health National Action Plan on Antimicrobial Resistance (2021-2025).4 This National Action Plan advocates for the judicious use of antimicrobials to limit any unintended consequences and antimicrobial resistance. This is commonly known as Antimicrobial Stewardship. Antibiotic resistance is largely driven by the overuse and misuse of antibiotics in people, animals and in the environment.4 Dentists are responsible for approximately 10% of antibiotic prescribing in humans globally.5 With several international studies of dental antibiotic prescribing demonstrating that overprescribing occurs frequently5, dentists have an opportunity to contribute significantly to slowing the development and spread of antibiotic resistance by optimising prescribing. This article aims to show how dentists can support good antimicrobial stewardship in their practice.