An analysis of the clinical appropriateness of out-of-hours emergency dental prescribing of antibiotics in Northern Ireland

Introduction The inappropriate prescribing of antibiotics in dentistry is potentially linked to the development of antimicrobial resistance, as well as being a considerable cost to healthcare. This study analysed the clinical appropriateness of antibiotics prescribed from 'walk-in' and telephone triage out-of-hours emergency dental clinics in Northern Ireland. 

Methods Patient and prescribing data were collected from two out-of-hour emergency dental clinics over a two-month period between September and December 2017. In total, 434 prescriptions were analysed. Clinical appropriateness was determined on a case-by-case basis for each prescription by referencing dental prescribing guidelines. 

Results Over half of the prescriptions analysed (52.77%) were judged as clinically inappropriate. A total of 19.12% of prescriptions were judged as inappropriate, as the antibiotic prescribed was not indicated for the diagnosis recorded by the clinician. Local measures were not attempted in 36.6% of cases. A significant difference (p = 0.002) was observed between the clinical appropriateness of prescriptions issued via walk-in and triage appointments with triage appointments issuing more clinically appropriate prescriptions. 

Conclusions A significant number of prescriptions provided in out-of-hours emergency dental clinics in Northern Ireland were judged to be inappropriate according to current dental prescribing guidelines.