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Oral Health

Dental researchers at The University of Manchester have changed international practice and reduced unnecessary prescriptions for antibiotics by on average of 8,000 per month in England alone.

Professor Helen Worthington and her team examined research findings on whether the administration of antibiotics before dental treatment to patients at risk of bacterial endocarditis (BE) - inflammation of the lining of the heart muscle and its valves caused by bacterial infection - made any difference to patient susceptibility.

Resistance to antibiotics is one of the greatest threats to public health worldwide and unnecessary prescribing of antibiotics can lead to increased resistance, which is of concern to the general population.

Until Professor Worthington's reviews the use of antibiotics had been an established dental practice and was advised in published guidelines.
Her team conducted two systematic Cochrane reviews: one in 2004 to investigate if the administration of penicillin in patients at risk before dental treatment prevented BE; and an update in 2008, extending the review to all antibiotics.

Both reviews showed that:

  • there was a lack of evidence to prove that prescribing antibiotics before dental work had any effect on the occurrence of BE;
  • the potential harms and costs of antibiotic administration outweighed any beneficial effects;
  • dental practitioners needed to advise patients on the risks and benefits of taking antibiotics before a decision is made.

As a result of this research, NICE guidelines were changed in 2008 and there has been a 78.6% drop in prescribing rates of antibiotics for dental patients in England. This has subsequently saved the NHS over £220,000 per year.

These Cochrane reviews have also informed international guidelines in the USA, Europe and Asia Pacific.

"As a result of this research, NICE guidelines were changed in 2008 and there has been a 78.6% drop in prescribing rates of antibiotics for dental patients in England. This has subsequently saved the NHS over £220,000 per year."

Helen Worthington / Professor of Evidence Based Care