Dentists lead the way in fight against antimicrobial resistance
Dentists are leading the way in the fight against antimicrobial resistance in primary care settings in Scotland, a new report shows.
The ‘Scottish One Health Antimicrobial Use and Antimicrobial Resistance (SONAAR) in 2019’ report highlights that 82.9% of all antibiotic use in 2019 occurred in the primary care setting, with dental accounting for 7.2 % of antibiotic use in primary care.
The report, written by Scottish Antimicrobial Prescribing Group (SAPG) members William Malcolm, Pharmaceutical Adviser and Clinical Lead for the SONAAR Programme, and Dr Julie Wilson, Lead for the Antimicrobial Resistance programme, also found that the rate of antibiotic use by dentists has reduced by 17.7% since 2015.
Professor Andrew Smith, chair of SAPG’s dental stewardship subgroup and Professor of Clinical Bacteriology, NHS Greater Glasgow and Clyde, said that while dentists are making progress in the reduction of unnecessary antibiotic prescribing, there is still a long way to go in tackling this major public health issue.
“Antibiotic prescribing by dentists in primary care in Scotland has been steadily decreasing year on year since 2015, which is a positive step in the right direction. However, there is evidence that the majority of drug resistant infections in Scotland originate in the community, so optimising antibiotic use in primary care is a major target for antimicrobial stewardship in Scotland.
“Although dental antibiotic use is reducing, we must continue to work hard in this area. Antibiotic resistance poses an urgent threat to human health, with some infections becoming more difficult or even impossible to treat.”
Dentists can currently prescribe a limited range of antibiotics on NHS prescription in Scotland with amoxicillin (68.0%) and metronidazole (28.8%) accounting for the majority of dental antibiotic use.
SAPG’s dental stewardship subgroup continues to coordinate work by stakeholders and support optimisation of dental antibiotic use. A key focus this year will be promoting the re-introduction of phenoxymethylpenicillin as an alternative to amoxicillin, as the first-line antibiotic in dental infections, and appraising national data and the evidence base for antibiotic course duration in dental infections.