Exploring dentist's engagement with antibiotic stewardship programs: a multicenter qualitative study in Pakistan.

Introduction: Antibiotic resistance is a growing threat to public health. Improper use of antibiotics can potentially lead to previously curable infections becoming unmanageable. Rampant unnecessary use of antibiotics is a serious problem within developing countries like Pakistan, and dental practices can often be traced as a major cause. Through the widespread implementation of antibiotic stewardship programs (ASP), medical and dental practitioners can be guided to appropriate prescribing practices and better patient education. Objective: To gauge current antimicrobial prescribing practices of dentists and their engagement with ASPs. Methods: 13 dental practitioners were interviewed using a semi-structured interview template. Interviews were recorded, transcribed, and subjected to thematic analysis. The subjects were selected from various dental hospitals within Punjab, using a convenient sampling approach. The sample size was based on the point of saturation of emerging themes. Results: Many factors were highlighted as causative for the current state of misinformation regarding antibiotic prescription practices among dental practitioners and patients. Awareness regarding ASP was severely lacking; however, most participants showed a positive perception regarding ASP and their impact. Institutional support and the need for implementation of such programs within the educational curriculum were noted as important steps for ASP implementation within dental hospitals of Pakistan. Conclusion: This study found that knowledge regarding ASP was insufficient among dental practitioners, owing to a lack of institutional policies and awareness among the practitioners. The outcome of the lack of these programs and misinformation among both patients and dentists is widely contributing to the current state of antibiotic resistance in Pakistan.