Testing Item for Dentists (Checklist)

Checklist for Antibiotic Prescribing in Dentistry
Pretreatment
†† Correctly diagnose an oral bacterial infection.
†† Consider therapeutic management interventions, which may be sufficient to
control a localized oral bacterial infection.
†† Weigh potential benefits and risks (i.e., toxicity, allergy, adverse effects,
Clostridium difficile infection) of antibiotics before prescribing.
†† Prescribe antibiotics only for patients of record and only for bacterial infections
you have been trained to treat. Do not prescribe antibiotics for oral viral
infections, fungal infections, or ulcerations related to trauma or aphthae.
†† Implement national antibiotic prophylaxis recommendations for the medical
concerns for which guidelines exist (e.g., cardiac defects).
†† Assess patients’ medical history and conditions, pregnancy status, drug
allergies, and potential for drug-drug interactions and adverse events, any of
which may impact antibiotic selection.

Prescribing
†† Ensure evidence-based antibiotic references are readily available during
patient visits. Avoid prescribing based on non-evidence-based historical
practices, patient demand, convenience, or pressure from colleagues.
†† Make and document the diagnosis, treatment steps, and rationale for antibiotic
use (if prescribed) in the patient chart.
†† Prescribe only when clinical signs and symptoms of a bacterial infection
suggest systemic immune response, such as fever or malaise along with local
oral swelling.
†† Revise empiric antibiotic regimens on the basis of patient progress and, if
needed, culture results.
†† Use the most targeted (narrow-spectrum) antibiotic for the shortest duration
possible (2-3 days after the clinical signs and symptoms subside) for otherwise
healthy patients.
†† Discuss antibiotic use and prescribing protocols with referring specialists.

Patient Education
†† Educate your patients to take antibiotics exactly as prescribed, take antibiotics
prescribed only for them, and not to save antibiotics for future illness.

Staff Education
†† Ensure staff members are trained in order to improve the probability of patient
adherence to antibiotic prescriptions.

National Center for Emerging and Zoonotic Infectious Diseases
Division of Healthcare Quality Promotion
CS267105-1