The effect of SARS-CoV-2 on the prescribing of antimicrobials and analgesics by NHS general dental practitioners in England

Aims To ascertain the effect of SARS-CoV-2 on the utilisation of antibacterial agents and analgesics in primary dental care. Methods Antibacterial agents and analgesics (eg paracetamol, aspirin) prescribed in England by general dental practitioners for the periods April-July 2019 and April-July 2020 were analysed. Results Antibacterial agents prescribed during COVID-19 restrictions in 2020 (799,282) were higher than a similar time period in 2019 (654,332) by 22%. Amoxicillin was used the most (2020 = 65.0%; 2019 = 66.3%) followed by metronidazole (2020 = 30.2%; 2019 = 28.7%). Erythromycin was prescribed at a similar rate, with lincosamides (clindamycin) prescribed more frequently in 2020 (2020 = 0.6%; 2019 = 0.5%). Clarithromycin was prescribed twice more often in 2020 (0.6%) in comparison to 2019 (0.3%). Co-amoxiclav (0.5%) and phenoxymethylpenicillin (0.3%) were prescribed at a similar rate. Analgesics use increased by 84% (2020 = 28,563; 2019 = 15,507). Use of dihydrocodeine tartrate increased (2020 = 40.9%; 2019 = 32.9%), followed by diclofenac sodium (2020 = 24.6%; 2019 = 12.8%). The opposite trend was seen in relation to ibuprofen with use decreasing (2020 = 19.4%; 2019 = 39.8%) while paracetamol use only slightly increasing (2020 = 15.1%; 2019 = 14.6%). Conclusions COVID-19 restrictions on dental care in England resulted in a marked increase in prescribing antibacterial agents and a very marked increase in prescription-only analgesics.