Can audit improve antibiotic prescribing in general dental practice?

Objective To investigate whether clinical audit can improve general dental practitioners' prescribing of antibiotics. Design An intervention study carried out in general dental practice in the North West of England. Method Information was collected over an initial six-week period from 175 g eneral dental practitioners on their current antibiotic prescribing practic es. The information collected was the antibiotic prescribed including dose, frequency and duration, the clinically presenting signs and conditions, th e medical history (if for prophylaxis), and any other reasons for prescribi ng. This was compared to the practitioners' antibiotic prescribing for a fu rther six-week period following an audit, which included an educational com ponent and the issuing of guidelines. Results During the initial period practitioners issued 2316 prescriptions f or antibiotics. This was reduced by 42.5% to 1330 during the audit. The maj ority of the antibiotics (81%) for both periods were prescribed for therape utic reasons. The most commonly prescribed antibiotics were amoxycillin (57 .6%), metronidazole (23.8%), penicillin (9.3%), erythromycin (4.8%) and a c ombination of amoxycillin and metronidazole (1.7%). The antibiotic regimens used by practitioners were significantly changed by the audit (P < 0.001) and there was a significant reduction in the number of prescriptions (P < 0 .05) which did not conform to national guidelines. Conclusions The results from this investigation support the conclusion that clinical audit, with the issuing of guidelines and an educational componen t, can change prescribing practices leading to a more rational and appropri ate use of antibiotics in general dental practice.