269 - Retrospective Study on Prescribing Practices in a Community Health Center

Purpose - The purpose of this study is to compare the trends of prescribing practices of antibiotics and opioids for the treatment of pediatric dental emergencies in a community health center.  

Methods – A retrospective chart review was conducted on 515 subjects 0-17 years old seen for dental-related emergency visits (procedure code corresponding with a limited exam or a problem focused concern) between January 1, 2019-January 1, 2020. Information collected included demographics, dental diagnosis, indication for antibiotics and/or opioids, and provider type. The entry was categorized for prescribing adherence (Yes/No) based on pooled literature and guidelines.
Results – There was no statistical difference for demographic characteristics, clinic setting, or ASA status. Antibiotics were indicated but not prescribed in 19 charts. Antibiotic was not prescribed but but indicated in 1 chart (p <.001). Antibiotics most incorrectly prescribed were amoxicillin and clindamycin (p <.001). Antibiotics were incorrectly prescribed for caries, trauma, irreversible pulpitis, reversible pulpitis, localized draining abscesses, and intra-oral, extra-oral swelling (p <.001). Out of the antibiotics that were prescribed but not indicated, the most common wrongful prescribing practice was diagnosis of irreversible pulpitis (42.1%) and localized abscess – draining (26.3%). Figure 1
Conclusion – We can conclude that there is a statistical significance of wrongful prescribing practices, especially when given the diagnosis of irreversible pulpitis and localized abscess. More emphasis should be given on the American Association of Pediatric Dentistry guidelines.