Table 6_Appropriateness of antibiotic prescribing in dental practice: results of two clinical audits conducted at a university hospital.docx

A secondary analysis evaluated the appropriateness of treatment modalities (A1C, A1NC). Statistical analyses were performed using Chi-squared or Fisher's exact tests. A total of 640 patients were included.

Antibiotics were prescribed in 30.3% of consultations. The proportion of appropriate prescriptions did not improve significantly between audits (A1 + A2: 71.9% vs. 77.6%, p = 0.822). Among the 193 patients who received antibiotics, inappropriate prescriptions remained common (I2, 72.5%), particularly among patients presenting with pulpal or periapical diseases and among those consulting primarily because of pain.

Among patients with a pulpal or periapical diagnosis who received antibiotics, 112 of 113 prescriptions (99.1%) were inappropriate, compared with 28 of 80 (35.0%) among other diagnoses. This pattern was consistent across the individual pulpal and periapical diagnostic subgroups. Inappropriate antibiotic prescribing remains frequent in dental emergency care.

A single audit-and-feedback intervention was insufficient to significantly modify prescribing practices, highlighting the need for sustained and multifaceted antimicrobial stewardship strategies focused on improving diagnostic accuracy and ensuring timely operative management.</p>