One of the unintended consequences of the COVID-19 lockdowns in England earlier this year was a 25% increase in the prescription of antibiotics by dentists, according to researchers at the National Health Service (NHS) and the University of Manchester.
Prescription rates were the highest in London, with an increase of 60% for the same period. The lowest increases, less than 10%, were in the southwest of England.
Antibiotic resistance (ABR) is a global problem that poses a significant threat to health and wealth, due to prolonged illnesses, longer hospital stays, and increased morality, said the FDI World Dental Federation.
The World Health Organization (WHO) has highlighted the urgency of tackling ABR by including it in its five platforms to global health and well-being. The WHO’s annual World Antimicrobial Awareness Week will be held from November 18 to November 24.
ABR affects everyone and needs to be tackled urgently, the FDI continued. If it continues to increase, infections resistant to drugs will be the number one cause of death globally within the next 30 years, the FDI added.
Antibiotics do not cure toothache, the FDI said, and most dental infections are amenable to treatment to remove the source of the infection without the need for antibiotics. In normal times, the FDI said, antibiotic-only treatment plans are rarely appropriate. Unnecessary use of antibiotics drives the development and spread of resistant infections.
“Antibiotics are lifesaving drugs. When people really need them, they really need to work,” said Dr. Wendy Thompson, author of the study, clinical academic in primary dental care at the University of Manchester, and member of the FDI ABR Working Group.
“Infections that are resistant to antibiotics pose a serious risk to patient safety, which is why the large rise in dental antibiotic prescribing (over 25% in the three months of April to June) is a huge concern,” Thompson said.
“After years of a downward trend, restricted access to dental care due to COVID-19 drove this sudden increase. We must guard against it happening again when the UK finds itself in another lockdown environment,” she said.
“We live in especially challenging times. Patients waiting for access to care often receive more antibiotics that those patients who receive the right treatment immediately. As dental care provision returns to a new normal in the COVID-19 era, it is important to ensure access to high-quality, urgent dental care and to optimize the use of antibiotics,” she said.
Acknowledging the urgency of the situation, FDI released a white paper, “The Essential Role of the Dental Team in Reducing Antibiotic Resistance,” which is supported by an online library of resources and accompanied by a massive open online course.
The FDI called the paper an important step forward in acknowledging that dentists around the world must be recognized for their role in preventing and treating dental infections and empowered to optimize their antibiotic prescribing.
“We are staring down a slow-motion pandemic, and urgent collective action is needed to slow it down,” said Dr. Gerhard K. Seeberger, FDI president. “Moving forward, the dental profession has a clear responsibility to engage, commit, and contribute to global, national, and local efforts to tackle antibiotic resistance.”
The study, “How Did COVID-19 Impact on Dental Antibiotic Prescribing Across England,” was published by BDJ.