The United States (U.S.) CDC states that in 2014, 266.1 million courses of antibiotics were prescribed to outpatients in the U.S., which amounts to 5 prescriptions for every 6 American adults yearly.17 It is estimated that up to 50% of all outpatient antibiotic use is inappropriate, including unnecessary prescriptions and inappropriate antibiotic course selection.18-20 Dentists prescribe approximately 13% of all antibiotic prescriptions and represent the third largest group of prescribers behind family medicine and internal medicine physicians.2 While the data are incomplete, a survey of dentists’ prescribing patterns found that 70% of dentists reported patients’ receiving inappropriate prescription of antibiotic prophylaxis prior to dental procedures and adherence to antibiotic prescribing guidelines by dental practitioners has been reported to be both variable and suboptimal.21 Among dentists, the most common antibiotics prescribed were amoxicillin, clindamycin, penicillin, azithromycin, and cephalexin.2 Overall, a high level of variability was reported in prescription rates between dental specialties, with Oral and Maxillofacial Pathology, Oral and Maxillofacial Surgery, and Oral and Maxillofacial Radiology prescribing on average over three times the number of antibiotic courses per practitioner compared to rates for dentists overall with Orthodontists having the lowest antibiotic prescription rates.2 Additionally, it was found that most antibiotic prescription courses were prescribed for 7-10 days.2
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