Antibiotic prophylaxis during dental implant placement in the UK

Background Antimicrobial resistance is a growing concern globally. It has previously been demonstrated that antibiotic prescribing for dental implants within the UK is varied with an apparent lack of guidance. This study aimed to establish current use of antibiotic prophylaxis during dental implant placements in the UK. Method An anonymous validated online questionnaire was distributed to members of the BAOS, BSSPD, BSP, ADI and ITI. Data were then collated and analysed. Results Two hundred and twenty-nine responses were received during April-July 2018. Fifty-five percent of dentists routinely prescribed antibiotics during implant placements. One-third did sometimes, but not routinely. Thirteen percent never prescribed. Reported protocols contained 61 different drug/dose combinations given over 124 different regimens. Those who prescribed routinely had significantly higher levels of training/qualification (P = 0.008), placed more implants (P = 0.014) and undertook more complex placements (P = 0.002) than non-prescribers. Seventy-three percent believed antibiotics decrease post-operative infection. One in ten felt they gave no benefit. Half believed they decrease implant failure. Over 90% would like national guidelines. Conclusion Significant variance in practice is clear. Almost half of practitioners did not routinely prescribe. Those who did were significantly more experienced, highly trained and did more complex placements. There was a difference between practitioners' perceived benefits of antibiotic prophylaxis and the evidence in the literature. There was a great desire for clearer guidance. Key points Protocols for antibiotic prophylaxis during dental implant placement vary enormously across the UK and the rest of the world. Routine antibiotic prescribing appears to have decreased in the UK since 2012 but is still used by the majority of practitioners. There is an overwhelming desire for clear guidance within the profession.