Title: 0330 - National Antibiotic Prescribing Trends Among US Dental Specialists


Qianxi Feng (Presenter)
Washington University in St. Louis

Katie Suda, Edward Hines, Jr. Veterans Affairs Hospital
Peter Lockhart, Carolinas Medical Center
Martin Thornhill, University of Sheffield
Kiraat Munshi, Express Scripts Holding Company
Rochelle Henderson, Express Scripts Holding Company
Victoria Fraser, Washington University in St. Louis School of Medicine
Michael Durkin, Washington University in St. Louis School of Medicine


Objectives: Reducing inappropriate antibiotic prescribing has been a major national quality improvement initiative by United States (US) public health agencies. Recent data demonstrated that antibiotic prescribing trends among US general dentists have remained stable and that inappropriate antibiotic prescribing is common. The purpose of this study is to assess longitudinal antibiotic prescribing practices among dental specialties in the US.

Methods: We collected monthly systemic antibiotic prescription (rx) counts, and rates per 100,000 beneficiaries, from Express Scripts Holding Company, a large pharmacy benefits manager in the US between 1/1/2013 and 12/31/2015. We used a quasi-Poisson regression model to analyze antibiotic prescription trends. Seasonal trends (when present) were quantified via “peak-to-trough ratios (PTTRs)” estimator in the regression model.

Results: Dental specialists prescribed 2.4 million antibiotics to our cohort of 38 million beneficiaries during the 3-year study period average annual rate (AAR) = 2,084 rx/100,000 beneficiaries. Of the dental specialties, oral and maxillofacial surgeons prescribed the most antibiotics (1,172,104 rx; AAR=1,017 rx/100,000 beneficiaries), followed by periodontists (527,038 rx; AAR=457 rx/100,000 beneficiaries), and endodontists (447,362 rx; AAR=388 rx/1000 beneficiaries). Longitudinal antibiotic prescribing trends were stable among all dental specialties in our regression model (p-values > 0.05). However, significant seasonal variation was observed in two specialties. For pediatric dentistry, we observed a spring-peaking trend in antibiotic prescription rates (PTTR: 1.18; 95%CI: 1.13-1.25). For orthodontists, we observed winter-peaking trends in antibiotic prescription rates (PTTR: 1.41; 95%CI: 1.21-1.71).

Conclusions: This is the first description of dental specialist prescribing in the US. In contract to medicine, overall antibiotic prescribing practices remained stable over time. Seasonal trends were observed in pediatric dentists and orthodontists. Similar seasonality in antibiotic prescribing has been observed in medical providers and may represent inappropriate treatment of upper respiratory viral infections. These results demonstrate opportunities to improve antibiotic prescribing among dental specialties within the US.

This abstract is based on research that was funded entirely or partially by an outside source:
CDC Epidemiology Center

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE.