Antibiotic prophylaxis stewardship prompts in dental-hygiene therapy for cardiac patients in Kenyan clinics: an interrupted time-series estimation of prescribing-ceiling thresholds

Antibiotic prophylaxis before invasive dental procedures in cardiac patients remains a contested area of stewardship, particularly in resource-constrained settings where dental hygienists and therapists increasingly make prescribing decisions. The analysis treats this indicator as a population-level proxy for antibiotic consumption pressure against which clinic-level prophylaxis prompts would operate. The sample yielded a mean of 39.064 (SD 15.715), with country values ranging from 6.80 in Eswatini to 62.90 in Egypt. The framework specifies how a stewardship prompt introduced at a defined ceiling would generate an expected discontinuity in prescribing rates, and how that discontinuity can be estimated from interrupted time-series data. The contribution is a transferable estimation strategy that connects national antibiotic-consumption context to local prophylaxis decisions, allowing Kenyan dental-hygiene programmes to calibrate prompts against observed consumption baselines rather than imported guidelines. Prescribing ceilings should be set relative to measured consumption pressure, not as fixed absolutes, and that interrupted time-series designs can identify the threshold at which a prompt produces durable change.