Dental Stewardship Implementation and Antimicrobial Resistance Awareness in India: Prescribing Patterns, Knowledge Gaps, and Barriers

Antimicrobial resistance (AMR) remains one of the most urgent global health challenges, with forecasts projecting up to 10 million deaths annually by 2050. India, one of the world’s largest consumers of antibiotics, faces significant pressure to optimise prescribing practices across all health sectors. Dental practitioners contribute nearly 10% of national antibiotic consumption, yet antimicrobial stewardship (AMS) in dentistry is underdeveloped and insufficiently studied.
This systematic review synthesises evidence on AMR awareness, AMS-related behaviours, and antibiotic-prescribing patterns among dental professionals in India.

A PRISMA-guided search (PubMed, Web of Science, Scopus, CINAHL, Google Scholar) identified studies published between January 2014 and December 2024. Fourteen studies involving 3,602 participants met inclusion criteria. Across the literature, notable deficiencies were observed in AMR understanding, clinical decision-making, and adherence to evidence-based prescribing. Inappropriate antibiotic selection, inaccurate dosing, unnecessary use of broad-spectrum agents, and poor alignment with dental treatment guidelines were frequently reported. Educational interventions produced short-term improvements, but there was limited evidence of sustained behavioural change. Key barriers included insufficient undergraduate AMS training, limited access to dental-specific guidelines, and the absence of formal stewardship structures in dental practice.

Strengthening AMS education, improving guideline accessibility, and establishing institutional stewardship frameworks are essential steps to support rational antibiotic use in Indian dentistry and contribute to national AMR containment strategies.