Scotland’s dentists are reporting a cut of almost one fifth in prescriptions for antibiotics since 2015 as the profession works to tackle the growing number of bacteria developing resistance to commonly used antibiotics.

Official statistics in the most recent annual report for Antimicrobial Resistance and Healthcare Associated Infection in Scotland revealed 82.9% of all antibiotic use in 2019 was in primary care – 7.2% of which was prescribed by dentists.

Now analysis by the Scottish Antimicrobial Prescribing Group (SAPG) is showing that the rate of antibiotic used by dentists has reduced by 17.7% since 2015.

The chair of SAPG’s dental stewardship subgroup, Andrew Smith, Professor of Clinical Bacteriology at NHS Greater Glasgow and Clyde, says while dentists are managing to reduce unnecessary antibiotic prescribing, there is still a long way to go:

“Antibiotic prescribing by dentists in primary care in Scotland has been steadily decreasing year on year since 2015, which is a positive step in the right direction,” he says.

“However, there is evidence that the majority of drug resistant infections in Scotland originate in the community, so optimising antibiotic use in primary care is a major target for antimicrobial stewardship in Scotland.

“Although dental antibiotic use is reducing, we must continue to work hard in this area. Antibiotic resistance poses an urgent threat to human health, with some infections becoming more difficult or even impossible to treat.”

Between them, amoxicillin (68.0% of prescribing) and metronidazole (28.8%) account for almost all dental antibiotic use.

SAPG’s dental stewardship subgroup is now focusing on promoting the reintroduction of phenoxymethylpenicillin (penicillin V) as an alternative to amoxicillin, as the first-line antibiotic in dental infections when antibiotics are unavoidable.

The move to the more narrow-spectrum penicillin, reducing the risk of developing resistance, reverses a trend seen in the 1990s to using broad-spectrum antibiotics which were considered superior to penicillin V, which was gradually replaced by amoxicillin in dental practice.

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