Patterns of drugs prescribed for dental outpatients in Nigeria : findings and implications

Fadare, JO and Oshikoya, KA and Obimakinde, OS and Sijuade, AO and Afolayan, JM and Adeleke, AA and Godman, Brian and Ojumu, ODO (2017) Patterns of drugs prescribed for dental outpatients in Nigeria : findings and implications. Acta Odontologica Scandinavica, 75 (7). pp. 496-506. ISSN 1502-3850 (https://doi.org/10.1080/00016357.2017.1347822)

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Abstract

Objectives: There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending hospital dental clinics in Nigeria. The findings used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns. Methods and materials: Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were subsequently evaluated. Patients referred for admission, without a prescription, or prescribed medicines without a documented diagnosis were excluded. Results: Overall, 607 prescriptions were analyzed, 314 (51.7%) were for females. Periodontal and gum diseases (414; 68.1%) was the most frequent diagnosis, followed by pulpitis (49; 8.2%), and dento-alveolar abscess (43; 7.1%). 1798 medicines were prescribed for all patients with a mean of 3.0±0.48 medicines per prescription. Antimicrobials (1178; 65.5%) and analgesics (620; 34.5%) were the only drug classes prescribed. Ascorbic acid and vitamin B complex were prescribed for 361(59.5%) patients. Among antimicrobials, amoxicillin (564; 95.1%) either alone or combined with clavulanic acid was the most frequently prescribed, followed by metronidazole (561; 94.6%). Brand name prescribing was also appreciably higher than WHO recommendations. Conclusion: Polypharmacy, brand name prescriptions, and the frequent prescription of antimicrobials were common practices at the dental clinic of this teaching hospital in Nigeria. We suggest a review of the current standard treatment guidelines in Nigeria so as to guide dentists on current knowledge and evidence based treatment of common oral diseases.