ArticlePharmacotherapy2022
High prescribing of antibiotics is associated with high prescribing of opioids in medical and dental providers.
Article in Pharmacotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- De-Implementing Low-Value Care in Dentistry: The Case for Choosing Wisely Campaigns.Community dentistry and oral epidemiology · 2026Article
- Article
- Association between high-intensity antibiotic prescribing and prescribing of psychotropic drugs in children: a population-based study.BMJ paediatrics open · 2026Article
- Identifying and analyzing high-prescribers of opioids and antibiotics using medicare part D data.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- The effect of antibiotic premedication on postoperative complications following dental extractions.Journal of public health dentistry · 2024Article
- Prescribing Patterns of High Opioid and Antibiotic Prescribers, Washington State, 2021: Do Some Prescribers Have Trouble Saying No?Open forum infectious diseases · 2024Article
- Learning from data in dentistry: Summary of the third annual OpenWide conference.Learning health systems · 2024Article
- Assessment of High-Volume Antibiotic and Opioid Prescribing by Medicare Part D Prescribers-United States, 2021.Public health reports (Washington, D.C. : 1974)Article
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
STUDY
objectiveHigh prescribers of antibiotics and opioids are an important target for stewardship interventions. The goal of this study was to assess the association between high antibiotic and high opioid prescribing by provider type.
designA national cross-sectional study.
setting2015-2017 Department of Veterans Affairs (VA) electronic health record data. POPULATION: Prescribers were identified as dentists (2017: n = 1346) and medical providers (physicians n = 23,072; advanced practice providers [APP] n = 7705; and other providers [pharmacists/chiropractors] n = 3674) (2017: n = 34,451). MEASUREMENTS: High prescribing was defined as being in the top 25% of visit-based rates of antibiotic or opioid prescribing (number of prescriptions/number of dental or medical visits). Multivariable random effects logistic regression with clustering by facility was used to assess the adjusted association between high antibiotic and opioid prescribing.
resultsMedical providers prescribed 4,348,670 antibiotic and 10,256,706 opioid prescriptions; dentists prescribed 277,170 antibiotic and 124,103 opioid prescriptions. Among all high prescribers of antibiotics, 40% were also high prescribers of opioids as compared to 18% of those who were not high antibiotic prescribers (p < 0.0001). High prescribing of antibiotics was associated with high prescribing of opioids in medical providers (adjusted odds ratio [aOR] = 2.87, 95% confidence interval [CI] = 2.72-3.04) and dentists (aOR = 8.40, 95% CI 6.00-11.76). Older provider age, specific US geographic regions, and lower VA facility complexity and rurality were also associated with high opioid prescribing by medical providers. In dentists, younger provider age, male gender, specific regions of the United States, and lower number of dentists in a facility were associated with high opioid prescribing. At the facility level, high dental prescribers of antibiotics or opioids were not at the same facilities as high medical prescribers, respectively (p < 0.0001).
conclusionsHigh antibiotic prescribing was associated with high opioid prescribing. Thus, stewardship interventions targeting both medication classes may have higher impact to efficiently reduce prescribing of medications with high public health impact. Provider-targeted interventions are needed to improve antibiotic and opioid prescribing in both dentists and medical providers.
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