UK medical organisations team up to raise awareness of antibiotic overprescription
LONDON, UK: Antibiotic resistance is one of the key challenges that dental and medical professionals will face over the coming decades, yet its causes and significance remain relatively unknown. To raise public interest in this issue, a number of UK-based medical organisations, spearheaded by the British Dental Association (BDA), joined forces to highlight the message that “Antibiotics do not cure toothache”. The campaign was launched to coincide with the World Health Organization’s World Antimicrobial Awareness Week, which takes place from 18 to 24 November each year.
According to the recently updated English surveillance programme for antimicrobial utilisation and resistance report, dentists in England wrote 17.6% more prescriptions for antibiotics in 2020 than they did in 2019. This stands in contrast to the period between 2016 and 2019, during which there was a cumulative decrease of 18.4% of antibiotic prescriptions for dental patients.
This increase in the number of prescriptions written is particularly worrisome because, according to the BDA, the number of patients who accessed England’s dental services in 2020 was less than half of that recorded in 2019 owing to the COVID-19 pandemic. In addition, a 2020 study published in the British Dental Journal found that, even prior to the pandemic, 80% of the antibiotics prescribed by dentists in the UK and the US resulted in unnecessary use that was not in accordance with general guidelines.
Dr Wendy Thompson, a general dental practitioner and the College of General Dentistry’s (CGDent) lead on antimicrobial prescribing and stewardship, wrote in an editorial for the College that the increased prescription of antibiotics in dental settings was largely the result of restrictions on access to in-person consultations.
“The COVID-19 lockdown dramatically reduced access to urgent dental care suddenly and almost totally,” she noted.
Dr Thompson continued: “For a while, remote care via advice, analgesics and antimicrobial (where appropriate) became the emergency guidance to get us out of a hole where there was simply not enough provision. Unsurprisingly during this time, rates of prescribing rather than procedures increased dramatically.”
In her article, Dr Thompson guided readers towards the book published by the Faculty of General Dental Practice (UK) Antimicrobial Prescribing in Dentistry—Good Practice Guidelines, of which the third edition was released in late 2020.
Dentists must be committed to reducing antibiotic usage
As research has demonstrated, careful and judicious prescription of antibiotics, a type of antimicrobial, can play a vital role in slowing down the development of antimicrobial resistance (AMR). A 2018 report from the UK government’s Health and Social Care Committee detailed that, if action were not taken to address this pressing issue, by 2050 an estimated ten million people would die each year as a result of AMR.
To combat this concern, the BDA, CGDent and the Association of Clinical Oral Microbiologists, as well as a host of other associations, have called on dental professionals and patients alike to remember that “Antibiotics do not cure toothache”. In addition, they have advised dental care teams to follow best practice and only prescribe antibiotics as an adjunct to clinical treatment and only when recommended by national guidelines.