# Stewardship of Antibiotics Prescribing in Belgian Dental Practice: A National Survey

## TL;DR

This study explores how Belgian dentists prescribe antibiotics and identifies ways to reduce misuse, which is crucial for combating antimicrobial resistance.

## Contribution

The study provides insights into factors influencing antibiotic prescribing in dentistry and proposes strategies to improve antimicrobial stewardship.

## Key findings

- Antibiotic prescribing is mainly influenced by patients' clinical signs, immune status, and medical/dental history.
- Only 25% of dentists were familiar with evidence-based guidelines for antibiotic use.
- Information technology support is seen as a useful tool for improving prescribing practices.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Antibiotics are the most important triggers of antimicrobial resistance.According to the World Health Organization, antibiotic resistance is rising to dangerously high levels in all parts of the world.

Antibiotics are the most important triggers of antimicrobial resistance.

According to the World Health Organization, antibiotic resistance is rising to dangerously high levels in all parts of the world.

Public health significance—Why is this work of significance to public health?
This national survey forms part of national actions to contain antimicrobial resistance.We examined factors influencing dentists’ prudent antibiotic prescribing, identified barriers to implementing evidence-based guidelines, and proposed strategies to strengthen antimicrobial stewardship in dentistry.

This national survey forms part of national actions to contain antimicrobial resistance.

We examined factors influencing dentists’ prudent antibiotic prescribing, identified barriers to implementing evidence-based guidelines, and proposed strategies to strengthen antimicrobial stewardship in dentistry.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Antibiotics continue to be prescribed for inappropriate indications in certain clinical situations. Continued efforts are needed to raise awareness and strengthen antibiotic stewardship in daily practice.Valuable insights into dentists’ antibiotic prescribing practices are offered, supporting targeted interventions to reduce antimicrobial resistance.

Antibiotics continue to be prescribed for inappropriate indications in certain clinical situations. Continued efforts are needed to raise awareness and strengthen antibiotic stewardship in daily practice.

Valuable insights into dentists’ antibiotic prescribing practices are offered, supporting targeted interventions to reduce antimicrobial resistance.

This national survey examined factors influencing dentists’ prudent antibiotic prescribing, barriers to implementing evidence-based guidelines in dental practice, and solutions to promote prudent prescribing. A validated online survey assessed dentists across five domains: participant characteristics, antibiotic prescribing practices, knowledge of antimicrobial resistance, barriers and solutions for prudent antibiotic use, and knowledge and adherence to evidence-based guidelines. A total of 811 dentists completed the survey (55.2% female). Antibiotic prescribing was mainly influenced by patients’ clinical signs and symptoms (79.0%), immune status (73.0%), and medical/dental history (66.0%). Key contributors to antimicrobial resistance were frequent antibiotic prescribing (97.1%), patient self-medication with leftover antibiotics (95.1%), and use of broad-spectrum agents when narrower options were available (90.3%). Only 25% of participants were familiar with evidence-based guidelines. Regression analysis showed region and professional experience as significantly associated with compliance with prophylactic/therapeutic antibiotic prescribing to protect patients (OR = 1.7–1.5; p < 0.025). Awareness of the evidence-based guidelines, working ≤ 30 h/week, and receiving prescription feedback were significantly associated with compliance with therapeutic antibiotic prescribing to protect society (OR = 1.8–1.5; p < 0.030). Information technology support was perceived as a useful aid for prescribing. Antibiotics are still prescribed for inappropriate indications. Continued efforts are needed to raise awareness and strengthen antibiotic stewardship in daily practice.