{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T16:11:50Z","timestamp":1779120710349,"version":"3.51.4"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The lack of procedure-specific, evidence-based dental antibiotic guidelines increases unnecessary and inappropriate antibiotic prescribing. The primary objective was to evaluate changes in antibiotic prescribing before and after antibiotic stewardship (AS) education by infectious diseases (ID) AS experts in addition to implementation of self-monitored antibiotic dashboards. A secondary objective was to link antibiotic prescriptions to standardized Current Dental Terminology (CDT) procedure codes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, multi-practice cohort study among 9 private practice periodontists who completed AS education by ID-AS experts. Antibiotic data, CDT codes, and medical histories were extracted from electronic dental records from 1 January 2021 through 30 June 2025. Individualized dashboards displayed longitudinal antibiotic prescribing and linkage to CDT procedure codes. Outcomes were compared across pre-education, post-education year 1, and post-education year 3 periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 11 795 antibiotic prescriptions for 7331 unique patients were identified; 85.6% were therapeutic (\u22653 days) and 14.4% were prophylactic. Prophylactic antibiotics for patients with prosthetic joint implants decreased by 89% by post-education year 3 (P &amp;lt; .05). Clindamycin and fluoroquinolone use declined by 85% (P &amp;lt; .001) and 31% (P &amp;lt; .15), respectively. Ten-day antibiotic durations decreased by 87% (P &amp;lt; .001) with a corresponding increase in courses of 3\u20135 days across multiple CDT procedure categories. Improvements were sustained 3 years after education without ongoing external audit and feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dentists demonstrated sustained improvements in antibiotic use following ID-AS\u2013led stewardship education and implementation of self-monitored antibiotic dashboards. Linking prescriptions to CDT codes supports future development of evidence-based dental antibiotic guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag287","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:48:51Z","timestamp":1778240931000},"source":"Crossref","is-referenced-by-count":0,"title":["Sustained Improvement in Antibiotic Prescribing Among Private Practice Dentists Following Antibiotic Stewardship Education and Dashboard Implementation"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7686-0670","authenticated-orcid":false,"given":"Debra A","family":"Goff","sequence":"first","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Pharmacy , Columbus, Ohio ,","place":["USA"]},{"name":"The Ohio State University College of Pharmacy , Columbus, Ohio ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E","family":"Klesper","sequence":"additional","affiliation":[{"name":"Ferris State University College of Pharmacy , Big Rapids, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3982-9516","authenticated-orcid":false,"given":"Kushal","family":"Dahal","sequence":"additional","affiliation":[{"name":"Ferris State University College of Pharmacy , Big Rapids, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fnu","family":"Sampada","sequence":"additional","affiliation":[{"name":"Ferris State University College of Pharmacy , Big Rapids, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minji","family":"Sohn","sequence":"additional","affiliation":[{"name":"Ferris State University College of Pharmacy , Big Rapids, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Guerin","sequence":"additional","affiliation":[{"name":"Ferris State University College of Pharmacy , Big Rapids, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Allen","sequence":"additional","affiliation":[{"name":"Northern Colorado Periodontics , Fort Collins, Colorado ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Basali","sequence":"additional","affiliation":[{"name":"Stoner Periodontics & Implant Specialists , Dublin, Ohio ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Edwards","sequence":"additional","affiliation":[{"name":"Implant Dentistry and Periodontics , Indianapolis, Illinois ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Scott Ferguson and Associates , Kimball, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krupa","family":"Patel","sequence":"additional","affiliation":[{"name":"Periodontic Associates of Port Huron , Port Huron, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Central Ohio Periodontics , Blacklick, Ohio ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Souyias","sequence":"additional","affiliation":[{"name":"Periodontic Associates of Port Huron , Port Huron, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Shumaker","sequence":"additional","affiliation":[{"name":"Northern Colorado Periodontics , Fort Collins, Colorado ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackson","family":"Stoner","sequence":"additional","affiliation":[{"name":"Dublin, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Stoner","sequence":"additional","affiliation":[{"name":"Stoner Periodontics & Implant Specialists , Dublin, Ohio ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Goff","sequence":"additional","affiliation":[{"name":"Dr's. Gilbert and Goff Prosthodontists , Columbus, Ohio ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"2026051811512188000_ofag287-B1","author":"American Dental Association Health Policy Institute"},{"key":"2026051811512188000_ofag287-B2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.3909","article-title":"Assessment of the appropriateness of antibiotic prescriptions for infection prophylaxis before dental procedures","volume":"2","author":"Suda","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2026051811512188000_ofag287-B3","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.japh.2016.08.015","article-title":"Antibiotic prescriptions in the community by type of provider in the United States, 2005\u20132010","volume":"56","author":"Suda","year":"2016","journal-title":"J Am Pharm Assoc"},{"key":"2026051811512188000_ofag287-B4","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1128\/AAC.02176-12","article-title":"Meta-analysis of antibiotics and the risk of community-associated clostridioides difficile infection","volume":"57","author":"Brown","year":"2013","journal-title":"Antimicrob Agents Chemother"},{"key":"2026051811512188000_ofag287-B5","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/j.adaj.2019.08.020","article-title":"Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling","volume":"150","author":"Lockhart","year":"2019","journal-title":"J Am Dent Assoc"},{"key":"2026051811512188000_ofag287-B6","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1001\/jama.2016.4151","article-title":"Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010\u20132011","volume":"315","author":"Fleming-Dutra","year":"2016","journal-title":"JAMA"},{"key":"2026051811512188000_ofag287-B7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/jac\/47.2.233","article-title":"Antibiotic prescribing knowledge of national health service general dental practitioners in England and Scotland","volume":"47","author":"Palmer","year":"2001","journal-title":"J Antimicrob Chemother"},{"key":"2026051811512188000_ofag287-B8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.adaj.2014.11.012","article-title":"The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints","volume":"146","author":"Sollecito","year":"2015","journal-title":"J Am Dent Assoc"},{"key":"2026051811512188000_ofag287-B9","volume-title":"Chairside guide: antibiotic use for the urgent management of dental pain and intraoral swelling","author":"American Dental 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Implantol"},{"key":"2026051811512188000_ofag287-B17","doi-asserted-by":"crossref","first-page":"S85","DOI":"10.1093\/ofid\/ofy210.206","article-title":"Duration of antimicrobial therapy: the impact of defaults","volume":"5","author":"Wrenn","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"2026051811512188000_ofag287-B18","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1177\/00220345251383863","article-title":"LinkMD: linking medical and dental records with 4 linking algorithms","volume":"105","author":"Patel","year":"2026","journal-title":"J Dent Res"},{"key":"2026051811512188000_ofag287-B19","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/cid\/ciz1118","article-title":"review of guidelines for dental antibiotic prophylaxis for prevention of endocarditis and prosthetic joint infections and need for dental stewardship","volume":"71","author":"Goff","year":"2020","journal-title":"Clin Infect 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