Antimicrobial resistance is an increasingly serious threat to global public health and patient safety. In Scotland, about 7% of antibiotics dispensed in community pharmacies are prescribed by dentists. However, despite national clinical guidance to support dentists make appropriate prescribing decisions, findings from surveys and audits suggest that dentists often prescribe antibiotics unnecessarily. It is known from earlier work that providing dentists with graphical audit and feedback about their antibiotic prescribing rate can lead to a substantial reduction in the number of antibiotics prescribed. One way to potentially enhance the effect of audit and feedback is to add a co-intervention, for example in-practice training. In Scotland, all NHS dental practices must undertake in-practice infection control training at least once every 3 years. The team providing this training worked with researchers at the University of Aberdeen and Dundee to develop a new component (TiPTAP) focusing on antibiotic prescribing and incorporating theory-informed behaviour change techniques.

This study aims to compare the effectiveness of individualised audit and feedback with or without TiPTAP training for reducing antibiotic prescribing in NHS dentists working in the NHS primary care dental practices. We will conduct a 2-arm parallel cluster randomised trial with a process evaluation to answer our research question.

The trial is led by Dr Beatriz Goulao (HSRU) and Claire Scott (NHS Education for Scotland). It is funded by NHS Education for Scotland.