Thompson W, McEachan R, Pavit S et al. Clinician and Patient Factors Influencing Treatment Decisions: Ethnographic Study of Antibiotic Prescribing and Operative Procedures in Out-Of-Hours and General Dental Practices. Antibiotics 2020; DOI:10.3390/antibiotics9090575.

Prescription in dental practice observed.

Observation of 76 appointments and 28 follow up interviews with dentists, patients and dental nurses were carried out. Appointments which entailed an antibiotic prescription lasted up to 15 minutes. Appointments which involved a dental procedure lasted up to one hour.

Factors which influenced prescribing behaviour (n = 31) were categorised as capability (eg awareness, guidelines, habits, skills), motivational (eg beliefs, financial burden, risk perception, patient safety) and opportunistic (eg competing demands, patient and peer influence). Previously unreported concerns of dentists included the lifetime impact of, for instance, extraction in an emergency, the stress of running late, concern for patient safety and an inability to follow up treatment efficacy.

Patient factors (n = 19) influencing treatment decisions included costs, their antibiotic beliefs, delaying tactics, the views of peer groups and their feelings about dentistry.

The reasons for prescribing antibiotics in an emergency, rather than carrying out an operative procedure, are multifaceted.