Page 27 - 7. FINAL draft Compendium 2019 2020_22072022

TRENDS IN ANTIBIOTIC PRESCRIBING AMONGST THE GOVERNMENT DENTISTS IN THE
DENTAL PRIMARY CARE IN THE STATE OF MELAKA
NMRR-17-618-35245

Nurhanna MA, Lee KL, Siti AK, Nurul AH

Objectives: To analyze the frequently prescribed antibiotics with the given dental
conditions amongst dental officers in the government dental primary care, to determine
whether it complies with the current National Antibiotic Guidelines (NAG), Clinical
Practice Guidelines (CPG), literature review and expert opinions and to identify the
possibility of dental officers’ background of training and practice affecting the prescription
pattern. Materials and Methods: The prescriptions for antibiotics issued by 200 dental
officers in 16 government clinics of all districts in Melaka from October 2017 to December
2017 were collected retrospectively and analyzed on use of antibiotic agent, reason for
prescribing and compliance with the current NAG and CPG. In addition, literature review
and expert opinions were gathered to come to a consensus for conditions that were not
found in the NAG and CPG. Results: A total of 3,186 antibiotics prescriptions were
analyzed. There were seven different types of antibiotics were prescribed by the dentists
and the mostly prescribed antibiotic was amoxicillin (61.9% (n=1,973). The antibiotics
prescribed was mostly used for endodontic cases (50.8%, n=1,619), out of which, about
two-thirds were used for localized periapical abscess (63.5%, n=1028). The vast majority
of the prescriptions were the non-compliance (83.7%, n=2,666), while 16.3% (n=520)
were compliance, with the current NAG, CPG literature reviews and recommendations. A
higher non-compliance was seen among Dental officers in Melaka Tengah (44.6%,
n=1420) and those who served between 1 to 2 years (33.0%, n=1052). Comparing the
training institutions of the prescribers of prescriptions analyzed, the non-compliance was
higher among who trained overseas (31.7%, n=1009), followed by local private university
(30.7%, n=979) and local public university (21.3%, n=678). Conclusion: This study
demonstrates poor adherence to guidelines, literature reviews and recommendations.
Irrational use of antibiotics is associated with increased antibiotic resistance. There is an
urgent need to improve antibiotics prescribing practice among the government dentists
in primary dental care in Melaka. A well-planned approach with the combination of audit,
feedback, education, local consensus and dissemination of guidelines and academic
detailing is needed to ensure appropriate prescription of antibiotics in the near future.

Presented at the 28 MDA SCATE 2021 on 28 February 2021
th
th
Dr Nurhanna binti Mohd Ali Dr Nurul Ashikin binti Husin
Dr Lee Kian Leong Jeremy District Dental Officer
Dr Siti Azura binti Ab Karim Melaka Tengah
All from Peringgit Dental Clinic Ministry of Health Malaysia
Ministry of Health Malaysia

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