Sutherland Susan, Born Karen, Singhal Sonica
Sunnybrook Health Sciences Centre, Toronto, ON.
Faculty of Dentistry, University of Toronto, Toronto, ON.
Can Commun Dis Rep. 2022 Nov 3;48(11-12):502-505. doi: 10.14745/ccdr.v48i1112a02.
Antimicrobial resistance due to over-prescribing in health care, including in dentistry, has been acknowledged as one of the top ten threats to global health by the World Health Organization. Dentistry is responsible for approximately 10% of antibiotics prescribed worldwide and research has shown up to 80% of antibiotics prescribed by dentists may be unnecessary. During the early months of the coronavirus disease 2019 pandemic, when dental offices handled only dental emergencies, it is probable that antibiotics were prescribed more readily and for longer duration to defer treatment for non-urgent cases. These unprecedented times strengthened the realization that strong dental antimicrobial stewardship practises are required in Canada to keep antimicrobial overuse under control. In countries, such as the United Kingdom and Australia, significant work is ongoing in this regard. Canada has made progress in developing tools for antimicrobial stewardship specifically for physicians in community settings, where the vast majority of antibiotics are prescribed, and it is now time to pay attention to antimicrobial stewardship in the field of dental care. Investments in developing a national level dental prescription database, along with monitoring, education and feedback mechanisms, can strongly support moving the needle on dentist-driven antibiotic overuse in Canada.
世界卫生组织已将医疗保健领域(包括牙科)过度开具抗菌药物导致的耐药性确认为全球健康面临的十大威胁之一。牙科约占全球抗生素处方量的10%,研究表明,牙医开具的抗生素中高达80%可能是不必要的。在2019冠状病毒病大流行的最初几个月,当牙科诊所只处理牙科急症时,可能更容易且更长时间地开具抗生素,以便推迟对非紧急病例的治疗。这些前所未有的时期让人们更加意识到,加拿大需要强有力的牙科抗菌药物管理措施来控制抗菌药物的过度使用。在英国和澳大利亚等国家,这方面正在开展大量工作。加拿大在为社区环境中的医生开发抗菌药物管理工具方面取得了进展,社区环境中开具了绝大多数抗生素,现在是时候关注牙科护理领域的抗菌药物管理了。投资建立国家级牙科处方数据库,以及监测、教育和反馈机制,能够有力支持在加拿大推动解决牙医导致的抗生素过度使用问题。