International Consensus on a Dental Antibiotic Stewardship Core Outcome Set

Introduction: Antibiotic resistance is a global health crisis. Ensuring responsible, appropriate use (stewardship) is an important for keeping antibiotics working as long as possible. Around 10% of antibiotics across health care are prescribed by oral health care professionals, with high rates of unnecessary use. To maximise the value from research to optimise antibiotic use in dentistry, this study developed international consensus on a core outcome set for dental antibiotic stewardship.

Methods: Candidate outcomes were sourced from a literature review. International participants were recruited via professional bodies, patient organisations, and social media, with at least 30 dentists, academics, and patient contributors in total. Outcomes scored "critical for inclusion" by >70% of the participants (dentists, academics, and patients) after 2 Delphi rounds were included in the core outcome set following a final consensus meeting. The study protocol was registered with the COMET Initiative and published in BMC Trials.

Results: A total of 33 participants from 15 countries, including 8 low- and middle-income countries, completed both rounds of the Delphi study. Antibiotic use outcomes (eg, appropriateness of prescribing), adverse or poor outcomes (eg, complications from disease progression), and a patient-reported outcome were included in the final, agreed core set. Outcomes relating to quality, time, and cost were not included.

Conclusions: This core outcome set for dental antibiotic stewardship represents the minimum which future studies of antibiotic stewardship in dentistry should report. By supporting researchers to design and report their studies in a way meaningful to multiple stakeholders and enabling international comparisons, the oral health profession's contribution to global efforts to tackle antibiotic resistance can be further improved.


Contributors

Wendy Thompson, Leanne Teoh, Celine Pulcini, Susie Sanderson, David Williams, Vanessa Carter, Carole Pitkeathley, Tanya Walsh

Publication

Journal: International Dental Journal
Volume: 73
Issue: 3
Pages: 456 - 462
Year: 2023
DOI: 10.1016/j.identj.2023.03.006

Further Study Information

Current Stage: Completed
Date: April 2021 - December 2021
Funding source(s): FDI World Dental Federation funded this study, supported by GSK Consumer Healthcare


Health Area

Disease Category: Dentistry & oral health

Disease Name: Antibiotic resistance

Target Population

Age Range: 0 - 120

Sex: Either

Nature of Intervention: Drug

Stakeholders Involved

- Clinical experts
- Consumers (patients)
- Patient/ support group representatives
- Researchers
- Service providers
- Service users
- Consumers (caregivers)
- Families

Study Type

- COS for clinical trials or clinical research
- COS for practice

Method(s)

- Delphi process
- Consensus meeting
- Systematic review

Candidate outcomes were sourced from a literature review. After 2 Delphi rounds and following a final consensus meeting, the final COS was reached.

Linked Studies

    No related studies


Related Links