Outpatient Antibiotic Prescribing by General Dentists in the United States from 2018 Through 2022

Background: Dentists play a role in combatting antimicrobial resistance. This analysis characterizes antibiotic prescribing changes by dentists after the American Dental Association's dental infection treatment guideline was released in 2019.

Methods: The Xponent (IQVIA) database was used to extract antibiotic prescriptions dispensed from 2018 through 2022. General dentist prescriptions were compared with total outpatient oral antibiotics and summarized by patient and provider characteristics. Census denominators were used to calculate prescribing rates per 1,000 people.

Results: Dentists prescribed 24.65 million antibiotics in 2018 compared with 25.17 million in 2022, resulting in 75.5 prescriptions per 1,000 people for both years. From 2018 through 2022, dentists prescribed 9.8% through 12.1% of all outpatient antibiotics. Females, patients 65 years and older, and patients in the Northeast received the most antibiotic prescriptions.

Conclusions: Prescribing by general dentists remained stable from 2018 through 2022 despite guideline recommendations to limit antibiotic use for dental infections. Variation by patient and provider characteristics may represent unnecessary antibiotic use.

Practical Implications: Antibiotic stewardship is needed to optimize prescribing in the dental care setting. The Centers for Disease Control and Prevention's Core Elements of Outpatient Antibiotic Stewardship framework can be adapted for dental stewardship implementation.