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Public Health

Evaluation of antibiotic prescribing patterns of an academic dental clinic before and after publication of guidelines regarding oral pain and swelling

(1276) Evaluation of Antibiotic Prescribing Patterns of an Academic Dental Clinic Before and After Publication of Guidelines Regarding Oral Pain and Swelling

Saturday, March 23, 2024
12:30 PM – 2:30 PM East Coast USA Time

    Primary (first) Author(s)

  • Michael P. Krajewski, Jr., PharmD MLS

    Adjunct Associate Professor
    State Univeristy of New York at Buffalo, School of Pharmacy and Pharmaceutical Sciences
    Buffalo, New York, United States

    • Presenting Author(s)

  • Michael P. Krajewski, Jr., PharmD MLS

    Adjunct Associate Professor
    State Univeristy of New York at Buffalo, School of Pharmacy and Pharmaceutical Sciences
    Buffalo, New York, United States

    • Co-Author(s)

  • CL

    Christopher Lepore

    Student Dentist
    State University of New York at Buffalo, School of Dental Medicine
    Buffalo, New York, United States

  • OS

    Oneida Shushe

    Student Dentist
    State University of New York at Buffalo, School of Dental Medicine
    Buffalo, New York, United States

  • DP

    Debanjan Paul

    Solutions Architect
    State Univeristy of New York at Buffalo, School of Pharmacy and Pharmaceutical Sciences, United States

  • JS

    Joseph Salamon

    Dental Services Director
    Seneca Nation Health Department, United States

    • Faculty Advisor/Preceptor(s)

  • JS

    Joseph Salamon

    Dental Services Director
    Seneca Nation Health Department, United States

Disclosure(s):
Michael P. Krajewski, Jr.: No financial relationships to disclose


Objectives: Dentists prescribe 10% of outpatient antibiotics in the United States. Recent publication of guidelines provide direction regarding antibiotic use in the treatment of dental pain and swelling. This project evaluates antibiotic prescribing patterns for oral infection of an academic dental clinic before and after publication of “Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intra-oral swelling” in November 2019.

Methods: A five-year cross sectional retrospective records review of data from the University at Buffalo School of Dental Medicine (UBSDM) for periods 3/1/2017 to 4/25/2022 was performed. Inclusion criteria for subjects were: UBSDM patients, over the age of 18, that received a prescription for an antibiotic or ICD10 code of K04.01 (reversible pulpitis), K04.02 (irreversible pulpitis, K04.1 (necrotic pulp), K04.4 (acute apical periodontitis), K04.5 (chronic apical periodontitis), K04.7 (Periapical abscess) within the study period. A chi-squared (χ 2) test for trend compared data before guideline publication (11/2019), during a 12 month guideline dissemination period (12/2019 - 11/2020), and 12 months after publication of the guidelines (12/2020 to 4/2022). A χ2 test of independence compared data from before and after guideline publication.

Results: No statistically significant difference was identified for antibiotic prescriptions per 100 oral infection visits in the pre-, dissemination, and post-guideline publication periods. (1.55,1.50, 1.55; p>0.05). Interestingly, a small decrease in prescriptions per 100 visits after the publication of the oral infection management guideline was noted. However, this difference did not reach statistical significance (1.55 vs 1.53, p>0.05).

Conclusions: Publication of a guideline regaridng oral pain and swelling did not significantly affect antibiotic prescribing. Further research is needed to determine guideline impact in other dental practice settings and other factors affecting antibiotic prescribing.