A Systematic Review of Dental Antibiotic Stewardship Interventions

Antimicrobial resistance poses a significant threat to global health, and antimicrobial stewardship aims to reduce inappropriate prescribing. Dentists prescribe around 10% of antibiotics globally, yet up to 90% of these prescriptions are inappropriate. A systematic review of three dental antibiotic stewardship interventions found high-certainty evidence that audit and personalized feedback with individualized behavior change messages can be effective. However, evidence for in-person education was low-certainty, and guideline dissemination alone was ineffective. The review recommends the need for well-powered, robust, randomised controlled trials, adequate follow-up, reporting internationally-agreed core outcomes, and parallel process evaluations to strengthen the body of evidence on dental antibiotic stewardship.