Marked reductions in outpatient antibiotic prescriptions for children and adolescents – a population-based study covering 83% of the paediatric population, Germany, 2010 to 2018

Background Prescribing of systemic antibiotics in general and of cephalosporins in particular in German paediatric outpatients has previously been reported to be higher than in other European countries. Aim Our objective was to assess recent trends in antibiotic prescribing in German children. Methods This study was conducted as consecutive annual cross-sectional analyses and included all children aged 0–14 years (n = 9,389,183 in 2018) covered by statutory health insurance in Germany. Annual antibiotic prescription rates from 2010 to 2018 were calculated for the age groups 0–1, 2–5, 6–9 and 10–14 years. Poisson regression was used to estimate trends of prescription rates by age group and antibiotic subgroup. Results Overall, the age-standardised antibiotic prescription rate decreased significantly by 43% from 746 prescriptions per 1,000 persons in 2010 to 428 per 1,000 in 2018 (p < 0.001). Reductions were most pronounced in the age groups 0–1 year (−50%) and 2–5 years (−44%). The age group 2–5 years exhibited the highest prescription rate with 683 per 1,000 in 2018 (0–1 year: 320/1,000; 6–9 years: 417/1,000; 10–14 years: 273/1,000). Cephalosporins (second and third generation) accounted for 32% of prescribed antibiotics. Conclusions Marked reductions in antibiotic prescribing during the last decade indicate a change towards more judicious paediatric prescribing habits. Compared with other European countries, however, prescribing of second- and third-generation cephalosporins remains high in Germany, suggesting frequent first-line use of these substances for common respiratory infections. Considerable regional variations underline the need for regionally targeted interventions.

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Prescription rate and treatment patterns for allergic rhinitis from 2010 to 2018 in South Korea: a retrospective study

Clinical and Molecular Allergy ◽

10.1186/s12948-021-00158-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jaemin Son ◽

Eun-San Kim ◽

Hee-seung Choi ◽

In-Hyuk Ha ◽

Donghyo Lee ◽

...

Keyword(s):

Allergic Rhinitis ◽

First Generation ◽

Age Groups ◽

Patient Characteristics ◽

Prescription Rate ◽

Cross Sectional ◽

First Choice ◽

Nasal Steroids ◽

National Patient ◽

Prescription Rates

Abstract Background There has been little investigation on how guidelines for allergic rhinitis (AR) treatment are applied in current clinical practice. We aimed to analyze prescription trends and patterns for AR treatment according to patient characteristics over a 9-year period in Korea. Methods We used cross-sectional data from the Korean Health Insurance Review & Assessment Service National Patient Sample from 2010 to 2018. We analyzed 1,719,194 patients with AR as the principal diagnosis. Prescription rates of antihistamines, steroids, and other drugs; combination prescriptions; and first-choice prescriptions were analyzed. Results The prescription rate of first-generation antihistamines decreased over the years (2010: 29.13; 2018: 23.41). By contrast, the prescription rate of systemic steroids (2010: 23.60; 2018: 28.70), nasal steroids (2010: 9.70; 2018: 14.67), and leukotriene receptor antagonists (LTRAs) (2010: 11.13; 2018: 26.56) increased. The prescription rate of steroids was lower in patients aged 0–5 years and ≥ 65 years than in other age groups and that of LTRAs was the highest in patients aged 0–5 years. The rate of combination prescribing antihistamines and nasal steroids increased (2010: 7.99; 2018: 12.09). The rate of first-choice prescriptions with antihistamines and nasal steroids also increased (2010: 4.72; 2018: 7.24). Conclusions The results confirmed a decrease in antihistamine prescriptions, especially with first-generation, and an increase in steroid and LTRA prescriptions in patients with AR in Korea. Regarding prescription patterns, steroids were increasingly prescribed in combination with antihistamines. However, the trend was opposite in the 0–5 years and ≥ 65 years groups.

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Changing antibiotic prescribing practices in outpatient primary care settings in China: Study protocol for a health information system-based cluster-randomised crossover controlled trial

PLoS ONE ◽

10.1371/journal.pone.0259065 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0259065

Author(s):

Yue Chang ◽

Yuanfan Yao ◽

Zhezhe Cui ◽

Guanghong Yang ◽

Duan Li ◽

...

Keyword(s):

Primary Care ◽

Antibiotic Prescription ◽

Intervention Group ◽

Control Group ◽

Antibiotic Prescribing ◽

Prescription Rate ◽

Feedback Intervention ◽

Primary Care Settings ◽

Cluster Randomised ◽

Prescription Rates

Background The overuse and abuse of antibiotics is a major risk factor for antibiotic resistance in primary care settings of China. In this study, the effectiveness of an automatically-presented, privacy-protecting, computer information technology (IT)-based antibiotic feedback intervention will be evaluated to determine whether it can reduce antibiotic prescribing rates and unreasonable prescribing behaviours. Methods We will pilot and develop a cluster-randomised, open controlled, crossover, superiority trial. A total of 320 outpatient physicians in 6 counties of Guizhou province who met the standard will be randomly divided into intervention group and control group with a primary care hospital being the unit of cluster allocation. In the intervention group, the three components of the feedback intervention included: 1. Artificial intelligence (AI)-based real-time warnings of improper antibiotic use; 2. Pop-up windows of antibiotic prescription rate ranking; 3. Distribution of educational manuals. In the control group, no form of intervention will be provided. The trial will last for 6 months and will be divided into two phases of three months each. The two groups will crossover after 3 months. The primary outcome is the 10-day antibiotic prescription rate of physicians. The secondary outcome is the rational use of antibiotic prescriptions. The acceptability and feasibility of this feedback intervention study will be evaluated using both qualitative and quantitative assessment methods. Discussion This study will overcome limitations of our previous study, which only focused on reducing antibiotic prescription rates. AI techniques and an educational intervention will be used in this study to effectively reduce antibiotic prescription rates and antibiotic irregularities. This study will also provide new ideas and approaches for further research in this area. Trial registration ISRCTN, ID: ISRCTN13817256. Registered on 11 January 2020.

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Community antibiotic prescribing for children in France from 2015 to 2017: a cross-sectional national study

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa162 ◽

2020 ◽

Author(s):

Nhung T H Trinh ◽

Robert Cohen ◽

Magali Lemaitre ◽

Pierre Chahwakilian ◽

Gregory Coulthard ◽

...

Keyword(s):

Broad Spectrum ◽

Antibiotic Prescription ◽

Antibiotic Use ◽

National Study ◽

Antibiotic Prescribing ◽

Broad Spectrum Antibiotic ◽

Duration Of Treatment ◽

Cross Sectional ◽

Prescription Rates ◽

Tract Infections

Abstract Objectives To assess recent community antibiotic prescribing for French children and identify areas of potential improvement. Methods We analysed 221 768 paediatric (<15 years) visits in a national sample of 680 French GPs and 70 community paediatricians (IQVIA’s EPPM database), from March 2015 to February 2017, excluding well-child visits. We calculated antibiotic prescription rates per 100 visits, separately for GPs and paediatricians. For respiratory tract infections (RTIs), we described broad-spectrum antibiotic use and duration of treatment. We used Poisson regression to identify factors associated with antibiotic prescribing. Results GPs prescribed more antibiotics than paediatricians [prescription rate 26.1 (95% CI 25.9–26.3) versus 21.6 (95% CI 21.0–22.2) per 100 visits, respectively; P < 0.0001]. RTIs accounted for more than 80% of antibiotic prescriptions, with presumed viral RTIs being responsible for 40.8% and 23.6% of all antibiotic prescriptions by GPs and paediatricians, respectively. For RTIs, antibiotic prescription rates per 100 visits were: otitis, 68.1 and 79.8; pharyngitis, 67.3 and 53.3; sinusitis, 67.9 and 77.3; pneumonia, 80.0 and 99.2; bronchitis, 65.2 and 47.3; common cold, 21.7 and 11.6; bronchiolitis 31.6 and 20.1; and other presumed viral RTIs, 24.1 and 11.0, for GPs and paediatricians, respectively. For RTIs, GPs prescribed more broad-spectrum antibiotics [49.8% (95% CI 49.3–50.3) versus 35.6% (95% CI 34.1–37.1), P < 0.0001] and antibiotic courses of similar duration (P = 0.21). After adjustment for diagnosis, antibiotic prescription rates were not associated with season and patient age, but were significantly higher among GPs aged ≥50 years. Conclusions Future antibiotic stewardship campaigns should target presumed viral RTIs, broad-spectrum antibiotic use and GPs aged ≥50 years.

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Cross-country variation in sleep disturbance among working and older age groups: an analysis based on the European Social Survey

International Psychogeriatrics ◽

10.1017/s1041610211000664 ◽

2011 ◽

Vol 23 (9) ◽

pp. 1413-1420 ◽

Cited By ~ 27

Author(s):

A. Dregan ◽

D. Armstrong

Keyword(s):

Sleep Disturbance ◽

Sleep Disturbances ◽

Age Groups ◽

European Social Survey ◽

Older Age ◽

European Countries ◽

Third Wave ◽

Age Group ◽

Cross Sectional ◽

Social Survey

ABSTRACTBackground: Sleep disturbance is a common complaint in the general population. There is, however, little cross-national comparative evidence on the prevalence of sleep disturbance and its association with age.Methods: Cross-sectional data from the third wave of the European Social Survey were used to compare both the prevalence of sleep disturbances and its relationship to age among 27,103 respondents over the age of 40 years from 23 European countries. The outcome measures for the study were based on the proportion of respondents reporting restless sleep over the past week and percentage change in the reporting of restless sleep between the 41–65 age group and the 66 and over age group.Result: The prevalence rate of sleep disturbance varied between and within age groups, as well as between the 23 European countries. Depressive symptoms (OR = 4.14), anxiety (OR = 2.80), and general health (OR = 1.52) were the strongest correlates of sleep disturbance among both the 41–65 age group and the over 66 age group. The highest positive correlation with change in restless sleep reports occurred with respect to health deterioration. Satisfaction with living standards showed the strongest negative association with change in restless sleep reports.Conclusion: There is considerable variation in reports of sleep disturbance across different European countries. Being in an older age group appears to be associated with worsening sleep, though not always. Different patterns of sleep disturbance seem to indicate the considerable variability of the aging experience across Europe.

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975. Clostridium difficile Infection and Antibiotic Prescription Rates in the Community: Explaining the Gender Gap

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy209.091 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S39-S39 ◽

Cited By ~ 1

Author(s):

Mariam Younas ◽

Julie Royer ◽

Hana Rac ◽

Julie Ann Justo ◽

P Brandon Bookstaver ◽

...

Keyword(s):

South Carolina ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Antibiotic Prescription ◽

Age Groups ◽

Incidence Rates ◽

Age Group ◽

Significant Difference ◽

Prescription Rates ◽

Carolina Population

Abstract Background Previous studies have reported higher incidence rates of community-associated Clostridium difficile infection (CA-CDI) in women than in men. This cross-sectional population-based study examines whether this difference in CA-CDI rates across genders is driven by or independent of antibiotic use. Methods Medicaid and State Employee Health Plan pharmacy claims for outpatient oral antibiotics and associated medical claims were utilized for estimation of community antibiotic prescription rates in South Carolina population 18 to 64 years of age from January 1, 2015 to December 31, 2015. CA-CDI cases were identified from National Healthcare Safety Network (NHSN) and South Carolina Infectious Disease and Outbreak Network (SCION) through complete enumeration of South Carolina population of the same age and study period as above. Incidence rates of CA-CDI were reported in both men and women 18–39 and 40–64 years of age before and after adjustments for antibiotic prescription rates in the same gender and age group. The 95% confidence intervals (CI) were calculated to examine statistical difference in incidence rates across genders within the same age group. Results During the calendar year 2015, a total of 1,564 CA-CDI cases were identified in South Carolina residents 18–64 years of age. The incidence rate of CA-CDI per 100,000 person-years was higher in women than in men in age groups 18–39 years (37.3 [95% CI: 32.8–41.8] vs. 21.0 [95% CI: 17.6–24.4]) and 40–64 years (86.4 [95% CI: 80.1–92.8] vs. 56.6 [95% CI: 51.2–61.9]. Similarly, antibiotic prescription rates per 100 person-years were higher in women than men in the 2 respective age groups (118.8 [95% CI: 118.3–119.3] vs. 54.3 [95% CI: 53.9–54.8] and 130.4 [95% CI: 129.8–130.9] vs. 83.8 [95% CI: 83.3–84.4]. After adjustments for antibiotic prescriptions, there was no significant difference in the incidence rates of CA-CDI per 100,000 prescriptions between women and men 18–39 years of age (31.4 [95% CI: 27.6–35.2] vs. 38.6 [95% CI: 32.4–44.8] and 40–64 years old (66.3 [95% CI 61.5–71.2] vs. 67.5 [95% CI: 61.1–73.8]). Conclusion Higher crude incidence rates of CA-CDI in women are likely due to higher outpatient antibiotic prescription rates in women when compared with men. Disclosures P. B. Bookstaver, CutisPharma: Scientific Advisor, <$1,000. Melinta Therapeutics: Speaker’s Bureau, <$1,000.

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Do NHS GP surgeries employing GPs additionally trained in integrative or complementary medicine have lower antibiotic prescribing rates? Retrospective cross-sectional analysis of national primary care prescribing data in England in 2016

BMJ Open ◽

10.1136/bmjopen-2017-020488 ◽

2018 ◽

Vol 8 (3) ◽

pp. e020488 ◽

Cited By ~ 10

Author(s):

Esther T van der Werf ◽

Lorna J Duncan ◽

Paschen von Flotow ◽

Erik W Baars

Keyword(s):

Primary Care ◽

Tract Infection ◽

Negative Binomial ◽

Antibiotic Prescription ◽

Additional Treatment ◽

Digital Data ◽

Future Research ◽

Antibiotic Prescribing ◽

Cross Sectional ◽

Prescription Rates

ObjectiveTo determine differences in antibiotic prescription rates between conventional General Practice (GP) surgeries and GP surgeries employing general practitioners (GPs) additionally trained in integrative medicine (IM) or complementary and alternative medicine (CAM) (referred to as IM GPs) working within National Health Service (NHS) England.DesignRetrospective study on antibiotic prescription rates per STAR-PU (Specific Therapeutic group Age–sex weighting Related Prescribing Unit) using NHS Digital data over 2016. Publicly available data were used on prevalence of relevant comorbidities, demographics of patient populations and deprivation scores.SettingPrimary Care.Participants7283 NHS GP surgeries in England.Primary outcome measureThe association between IM GPs and antibiotic prescribing rates per STAR-PU with the number of antibiotic prescriptions (total, and for respiratory tract infection (RTI) and urinary tract infection (UTI) separately) as outcome.ResultsIM GP surgeries (n=9) were comparable to conventional GP surgeries in terms of list sizes, demographics, deprivation scores and comorbidity prevalence. Negative binomial regression models showed that statistically significant fewer total antibiotics (relative risk (RR) 0.78, 95% CI 0.64 to 0.97) and RTI antibiotics (RR 0.74, 95% CI 0.59 to 0.94) were prescribed at NHS IM GP surgeries compared with conventional NHS GP surgeries. In contrast, the number of antibiotics prescribed for UTI were similar between both practices.ConclusionNHS England GP surgeries employing GPs additionally trained in IM/CAM have lower antibiotic prescribing rates. Accessibility of IM/CAM within NHS England primary care is limited. Main study limitation is the lack of consultation data. Future research should include the differences in consultation behaviour of patients self-selecting to consult an IM GP or conventional surgery, and its effect on antibiotic prescription. Additional treatment strategies for common primary care infections used by IM GPs should be explored to see if they could be used to assist in the fight against antimicrobial resistance.

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20. Fluoroquinolone and Overall Outpatient Antibiotic Prescribing Trends in Adults, 2011 to 2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa417.019 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S10-S11

Author(s):

Katryna A Gouin ◽

Laura M King ◽

Monina Bartoces ◽

Sarah Kabbani; Rebecca M Roberts ◽

Sharon Tsay ◽

...

Keyword(s):

United States ◽

Older Adults ◽

Adverse Events ◽

Antibiotic Prescription ◽

The United States ◽

Antibiotic Prescribing ◽

Age Group ◽

Prescribing Practices ◽

Prescribing Trends ◽

Prescription Rates

Abstract Background Fluoroquinolones (FQs) are the third most commonly prescribed antibiotics among U.S. outpatients, and the second most commonly prescribed class among adults ≥ 65 years of age. However, FQ use has been associated with severe adverse events, especially among older adults. As a result, in 2016 the U.S. Food and Drug Administration (FDA) issued warnings against FQ use when other agents may be effective. We assessed changes in outpatient FQ prescribing relative to overall antibiotic prescribing from 2011 to 2018. Methods We estimated annual antibiotic prescription rates in adults ≥ 20 years of age for all classes and FQs using national prescription dispensing count data from IQVIA Xponent (numerator) and census estimates (denominator) for 2011 to 2018. We used Poisson models to estimate prevalence rate ratios (PRR) and 95% confidence intervals (CIs) comparing antibiotic prescription rates overall and stratified by age group from 2011 to 2018. The Chi-square test was used to compare the percent decrease in rates between age groups. Results From 2011 to 2018, prescription rates in adults for all antibiotics decreased by 2% (PRR 0.98, 95% CI: 0.98-0.98); FQ prescription rates decreased by 30% (PRR 0.70, 95% CI: 0.69–0.70), with the largest decline from 2015–2018 (Figure 1). Adults ≥ 65 years had the highest FQ prescription rates for 2011 to 2018, at a rate 2.37 (95% CI: 2.32,2.42) times that of adults 20–64 years (Figure 2). The FQ prescribing rate in adults 20–64 experienced a greater decrease from 2011 to 2018 than the rate in adults ≥ 65 years (p< 0.0001), with a 35% decrease (PRR 0.65, 95% CI: 0.65, 0.65) in adults 20–64 years compared to a 29% (PRR 0.71, 95% CI: 0.71-0.71) decrease in adults ≥ 65 years (Figure 2). Decreases in total outpatient antibiotic and fluoroquinolone prescribing rates among adults in the United States from 2011 to 2018 Decreases in outpatient fluoroquinolone prescriptions per 1,000 persons by age group in the United States from 2011 to 2018 Conclusion FQ prescribing decreased markedly compared to overall antibiotic prescribing from 2011 to 2018, which was likely due in part to FDA warnings on FQ-associated adverse events. However, FQ prescribing among older adults remained high during this period and did not decrease as much as in younger adults. Further evaluation of the diagnoses associated with prescribing may provide additional opportunities to optimize FQ prescribing practices, especially among older adults. Disclosures All Authors: No reported disclosures

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222. Comparison of Outpatient Antibiotic Prescriptions in a High Prescribing State, 2016–2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.266 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S112-S112

Author(s):

Christopher D Evans ◽

Youssoufou Ouedraogo ◽

Amelia Keaton ◽

Milner Staub

Keyword(s):

Antibiotic Prescription ◽

Group Analysis ◽

Age Groups ◽

Population Data ◽

Antibiotic Use ◽

Antibiotic Prescribing ◽

Prescribing Trends ◽

Amoxicillin Clavulanate ◽

Prescription Rates ◽

Outpatient Settings

Abstract Background About 80% of antibiotic prescriptions are written in outpatient settings. Outpatient antibiotic use (AU) is highest in the Southern United States. Tennessee consistently has one of the highest AU rates in the country. Previous analyses found that 1,195 prescriptions were filled in Tennessee per 1,000 total population in 2016. Moreover, 50% of all outpatient antibiotic prescriptions were written by 9.3% of prescribers. We sought to assess Tennessee outpatient antibiotic prescribing trends, comparing 2016 with 2018 data. Methods The Tennessee IQVIA outpatient antibiotic prescription dataset from January 1 to December 31, 2018 was analyzed and compared to 2016 results. Orally administered antibacterial agents were included. Patients < 20 years old were classified as pediatric. County level population data were obtained from the Tennessee Department of Health. Antibiotic prescription rates were calculated as antibiotics prescribed per 1,000 population in the specified age group. Analysis was performed using SAS 9.4. Results The statewide AU rate decreased from 1,195 in 2016 to 1,074 in 2018 per 1,000 population. Consistent with the previous analysis, female patients (1,288), those over 65 years (1,459), and those < 2 years (1,372) had the highest rates of AU in 2018. Lower rates were observed in all age groups in 2018 except for the 3–9 years group. While narrow penicillins and macrolides remain the most frequently prescribed antibiotics, amoxicillin-clavulanate and ciprofloxacin fell out of the top five antibiotics used in adults, and amoxicillin-clavulanate fell out of the top five antibiotics used in pediatrics. Similar to 2016, 9.2% (3,098) of the providers contributed to 50% of the total prescriptions in 2016, and 2,090 of the 2,994 (69.8%) 2016 highest prescribing providers were also among the highest prescribers in 2018. Conclusion Despite a decline in outpatient antibiotic prescription volume, Tennessee remains one of the nation’s highest prescribing states. While a decline in broad spectrum antibiotic prescriptions may indicate a shift to more appropriate usage, these data do not include indication, excluding appropriate use assessment. Identifying and focusing antibiotic stewardship interventions for consistently high prescribers remains a priority for Tennessee. Disclosures All Authors: No reported disclosures

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Ten-year trends of hypertension treatment and control rate in Korea

Scientific Reports ◽

10.1038/s41598-021-86199-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kwang-il Kim ◽

Eunjeong Ji ◽

Jung-yeon Choi ◽

Sun-wook Kim ◽

Soyeon Ahn ◽

...

Keyword(s):

Age Groups ◽

Favorable Effect ◽

Age Group ◽

Hypertension Treatment ◽

Treatment Rate ◽

Cross Sectional ◽

The Past ◽

Nationally Representative ◽

Multistage Sampling ◽

And Control

AbstractWe analyzed the Korean National Health and Nutrition Examination Survey (KNHANES) database to determine the trends of hypertension treatment and control rate in Korea over the past 10 years. In addition, we tried to investigate the effect of chronic medical conditions on hypertension management. We investigated the hypertension prevalence, awareness, treatment, and control rate from 2008 to 2017. KNHANES, which uses a stratified multistage sampling design, is a cross-sectional, nationally representative survey conducted by the Korean government. A total of 59,282 adults (≥ 20 years) were included, which was representative of the total population of around 40 million Koreans per year. The mean age was 50.7 ± 16.4 years and 42.6% were male. The prevalence of hypertension, hypercholesterolemia, diabetes mellitus, and obesity significantly increased over the 10 years. During this period, the hypertension treatment and control rate significantly improved. Hypertension treatment rate was significantly lower in the younger age group compared to the older age group, but the control rate among the treated patients was not significantly different between age groups. The treatment and control rates of hypertension were higher in patients with multimorbidity, which implies that it has a favorable effect on the treatment and control of hypertension. Hypertension treatment and control rate have improved over the past 10 years. The higher treatment and control rate in patients with multimorbidity suggest that the more aggressive surveillance might be associated with the improvement of hypertension treatment and control rate in Korea.

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Comparison of Prevalence of Periodontitis with Different Indices in Population of District Ghaziabad

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672041 ◽

2016 ◽

Vol 04 (01) ◽

pp. 023-030

Author(s):

Vimal Kumar ◽

Pallak Arora ◽

Manish Khatri ◽

Shivani Sharma ◽

Sumit Malhotra ◽

...

Keyword(s):

Periodontal Disease ◽

Total Population ◽

Age Groups ◽

Cross Sectional Study ◽

Sample Population ◽

Age Group ◽

Cross Sectional ◽

Multi Stage ◽

Younger Age ◽

Study Population

Abstract Objective: To estimate the prevalence of periodontal disease with different indices. Methods & materials: The study population consisted of multistage stratified random sample of 1300 subjects from total population of district Ghaziabad. A cross-sectional study was conducted with multi stage stratified random sampling techniques to select the sample population. The subjects were divided into different age groups and the periodontal assessment was made on the basis of CPITN index and ESI Index. Results: The CPITN has shown to estimate incorrect periodontal disease prevalence because of its underestimation of the disease severity. A huge difference was noticed in the prevalence rate of periodontitis when subjects were examined with ESI index. Conclusion Periodontal disease was found to be highly prevalent in the study population and severity of disease increased with age. More number of subjects in younger age group were found to be healthy.

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