An audit of antimicrobial prescribing by dental practitioners in the north east of England and Cumbria.

BACKGROUND: Inappropriate prescribing of antimicrobials is a significant threat to global public health. In England, approximately 5% of all antimicrobial items are prescribed by dentists, despite the limited indications for their use in the treatment of oral infections in published clinical guidelines. The objective of this study was to survey antimicrobial prescribing by dental practitioners in North East England and Cumbria, identify educational and training needs and develop a self-assessment tool that can be used for Continued Professional Development by individual practitioners. METHODS: During October 2016, 275 dental practitioners used a standardised form to record anonymous information about patients who had been prescribed antimicrobials. Clinical information and prescribing details were compared against clinical guidelines published by the Faculty of General Dental Practitioners UK. RESULTS: Dental practitioners provided data on 1893 antimicrobial prescriptions. There was documented evidence of systemic spread, such as pyrexia in 18% of patients. Dentists recorded patients' pain (91.1% of patients), local lymph gland involvement (41.5%) gross diffuse swelling (55.5%) dysphagia (7.2%) and trismus (13.6%). Reasons for prescribing antimicrobials included patient expectations (25.8%), patient preference (24.8%), time pressures (10.9%), and patients uncooperative with other treatments (10.4%). The most commonly prescribed antimicrobials were amoxicillin, accounting for 61.2% of prescriptions, followed by metronidazole (29.9%). Most prescriptions for amoxicillin were for either 5 days (66.8%) or 7 days (29.6%) and most prescriptions for metronidazole were for a 5-day course (65.2%) or 7-day (18.6%) course. CONCLUSION: In most cases, when an antimicrobial was prescribed, practitioners used the correct choice of agents and usually prescribed these at the correct dose. However, some evidence of suboptimal prescribing practices when compared to the Faculty of General Dental Practitioner guidelines were identified. The audit has identified training needs across the region and aided the development of Continued Professional Development sessions. Further work to identify barriers and facilitators for improving antimicrobial prescribing and determining appropriate methods to improve clinical practice are required.

Data on expert system-econometric entropy informatics model for adjudicating residential building project costs.

This data article presents an expert system and econometric entropy-based informatics model for residential building project for cost judgment and decisions in residential building project. The data was obtained using purposive sampling technique to select projects completed between 2009 and 2011in Lagos state Nigeria, the project were examined for their cost centres. Also, As-built cost of one thousand(1000) samples of trained As-built cost of residential building projects trained with Neural network with Levenberg Marqua after being adjusted and modified with econometric factors like inflation index, cost entropy and entropy factor to stabilized the data and were used to form and train neural network used. Probability technique was used to generate risk impact matrix and influence of entropy on the cost centres. A parametric model similar to hedonic models was generated using the utility parameters within the early and late elemental dichotomy. The model was validated through comparative analysis of the econometric loading attributes using Monte Carlo technique of SPSS software extracting the contingency coefficient. The data of the model can provide solution to the problems of knowing the cost implication of a future project and also enable a builder or contactor load cost implication of an unseen circumstance even on occasion of deferred cost reimbursement.