Costs-Outcome Description Arising From Side Effects due the Over-Prescription of Antibiotics in Oral Healthcare in Chile

OBJECTIVE: The aim of this study is to investigate the financial consequences of immediate side effects of antibiotic over-prescription in dentistry from a societal perspective; to improve resource allocation and antibiotic prescribing practices.

METHODS: A cost-outcome description study was conducted, employing a decision tree model to estimate the costs arising from antibiotic over-prescription in oral healthcare. The model is based on a review of the relevant literature regarding current antibiotic prescribing practices in dentistry. It estimated the annual antibiotic prescription from 31 233 registered dentists in Chile (i.e., 1 624 428 prescriptions), with 55% of these considered unnecessary. Direct costs from a societal perspective were evaluated over a one-year time horizon, including medical services, lost income, and transportation costs. A sensitivity analysis was performed to assess the robustness of the findings.

RESULTS: The total societal cost of antibiotic over-prescription in dentistry was estimated at CLP: 8545478768 (USD: 9519516), including CLP: 3275870238 (USD: 3649263) for unnecessary prescriptions, and CLP: 5269608530 (USD:5870253) for adverse reactions. The sensitivity analysis indicated that variations in the percentage of unnecessary prescriptions significantly influenced the overall costs, ranging from CLP: 6991755356 (USD: 7788695) to CLP: 10099202180 (USD: 11250337).

CONCLUSION: The study evaluated the economic burden of antibiotic over-prescription in oral healthcare, in terms of adverse reactions, highlighting the need for better prescribing practices. It suggested that significant cost-savings (USD: 9.5 million) could be achieved by reducing unnecessary antibiotic prescriptions. By addressing this challenge, we can not only alleviate the financial burden on society but also contribute to the global fight against antimicrobial resistance.