Abstract

RAMNARAIN, P  and  SINGH, S. Oral antibiotic prescription patterns for dental conditions at two public sector hospitals in Pietermaritzburg, KwaZulu-Natal. S. Afr. dent. j. [online]. 2022, vol.77, n.2, pp.85-91. ISSN 0375-1562.  http://dx.doi.org/10.17159/2519-0105/2022/v77no2a5.

INTRODUCTION: Antibiotic resistance is a growing public health concern. Yet, there is a paucity of published data in KwaZulu-Natal on antibiotic prescription trends and patterns related to dental use. STUDY OBJECTIVES: The objectives of this study were to identify the range of dental conditions for which oral antibiotics are prescribed at two public health settings (Institution A and B) in the Pietermaritzburg Complex, KwaZulu-Natal and to explore practitioner understanding of the indications for antibiotic prescription for dental conditions. METHODS: The study used a two-phased approach and collected a combination of qualitative and quantitative data. Phase 1 comprised a retrospective clinical chart review (n=720), while phase 2 comprised a focus-group discussion with purposively selected health care practitioners at each institution. RESULTS: The results of the retrospective clinical chart review indicated that dental abscesses were the most common dental infections requiring oral antibiotic therapy (n= 479; 66%), followed by acute alveolar osteitis (dry socket) (n=110; 15%), dental impactions (n=78; 11%) and dental extractions (n=62; 9%). At Institution A, antibiotic therapy was prescribed for conditions such as trismus (n=13; 6%), soft palate swelling of unspecified origin (n=9; 4%), fibrous epulis (n=6; 3%) and acute herpes simplex (n=2; 1%). Interestingly, antibiotics were not prescribed at Institution B for the same dental conditions. Antibiotic therapy was also prescribed for eruption pain (n=4; 1%) and for cases when patients did not bring their inhaler for asthma treatment (pump) (n=3; 1%). The findings from the focus-group discussions suggested that there is a need to improve practitioner understanding of the indications for antibiotic prescriptions for dental conditions. CONCLUSION: This study showed some differences in antibiotic therapy prescription patterns at the two public health institutions, especially for dental conditions that did not require such management. This suggests a need for consensus-building among health professionals and the provision of more dedicated guidance for antibiotic prescription in the management of dental conditions.

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