Changes in Antibiotic Redemption Related to Hungarian Dental Care During COVID-19

Nándor Kalas; Attila Nagy; Nóra Kovács; Viktor Dombrádi; Gábor Bányai; Klára Bíró; Klára Boruzs

doi:10.1016/j.identj.2024.02.010

Changes in Antibiotic Redemption Related to Hungarian Dental Care During COVID-19

Int Dent J. 2024 Mar 8:S0020-6539(24)00064-9. doi: 10.1016/j.identj.2024.02.010. Online ahead of print.

Authors

Nándor Kalas¹, Attila Nagy², Nóra Kovács³, Viktor Dombrádi⁴, Gábor Bányai⁵, Klára Bíró⁵, Klára Boruzs⁶

Affiliations

¹ Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary; Dental Care Service, University of Debrecen Clinical Center, University of Debrecen, Debrecen, Hungary.
² Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary.
³ Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
⁴ Department of Patient Safety, Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary.
⁵ Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary.
⁶ Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary. Electronic address: boruzs.klara@econ.unideb.hu.

PMID: 38461095
DOI: 10.1016/j.identj.2024.02.010

Abstract

Introduction and aims: Antibiotic resistance is a global health problem that can affect individuals, health systems, and the economy. Our aim was to investigate how the redemption of antibiotics and the associated dental care changed during COVID-19 in Hungary.

Methods: The ICD codes for the infections for which antibiotics should be prescribed in dental care were identified based on the professional recommendation. The database was provided by the National Health Insurance Fund Manager of Hungary. Pearson's chi-squared test with Bonferroni correction was used to compare both the redemption of antibiotics and the associated dental care based on the recommendations in the year 2020 of the COVID-19 and the 2 preceding years.

Results: There were fewer antibiotic redemptions and associated dental care in 2020 than in 2018 and 2019. The ratio of professionally relevant and nonrelevant antibiotics redeemed did not change significantly between 2018 and 2019, but the proportion of antibiotics redeemed following recommendations increased significantly during the COVID-19 year of 2020 compared to the previous 2 years. The proportion of all dental care involving antibiotic redemptions increased significantly from 2018 to 2019, and then showed a further increase in 2020. The sex and age of the patient did not affect these findings, while the type of dental care did alter the trends in some cases.

Conclusions: Antibiotics in dentistry are required only for very low proportion of cases, due to the nature of dental care where most infections such as caries and periodontal disease could be managed without resorting to antibiotics. Antibiotic redemptions during COVID-19 pandemic period increased compared to the pre-pandemic period in Hungary. Therefore, Hungarian policy makers need to develop control systems to promote the correct use of antibiotics in dental care.

Clinical relevance: It is important to reduce unjustified use of antibiotics so as to curb the emergence of antibiotic resistance organisms.

Keywords: Antibiotics; COVID-19; Dental care; Hungary; Pandemic; Redemption.