Background Antibiotics have played a major role in the treatment of infectious diseases since 1928; however, the overuse of antibiotics has contributed to the development of antibiotic-resistant pathogens. According to the Centers for Disease Control and Prevention (CDC), at least 30% of prescribed antibiotics are unnecessary in the USA. Following the CDC checklist, practitioners should avoid non-evidence-based historical prescriptions and ensure that prescriptions are not written on the basis of patient expectations, convenience, or pressure from colleagues. In certain cases, such as when a patient present with extra-oral swelling, trismus, or the need for a surgical intervention, an appropriate regimen of antibiotics is indicated; otherwise, systemic antibiotics should not be the routine treatment of choice. This study aims to determine and assess adherence to CDC guidelines for antibiotic prescriptions in dental clinics at National Guard Primary Healthcare Centers, Western Region, Saudi Arabia.

Methods The study was carried out at National Guard Primary Healthcare Centers in Western Region, Saudi Arabia. Records of all patients with antibiotic prescriptions during their dental visits from January 2017 to June 2018 were sampled through simple random sampling; medically compromised patients were excluded. Dentists’ adherence to the guidelines was assessed. MS Excel was used for data entry, and SPSS version 23 was used to analyze the data, using the chi-squared test for significance.

Results A total of 385 clinical records were reviewed, of which 30% of the antibiotics were ordered without proper documentation of the diagnosis. Only 11.2% of the prescriptions adhered to the guidelines, while the other 88.8% did not follow the guidelines, including improper documentation. There was a significant difference between the prescriptions that did and did not follow the guidelines. On the other hand, the relation between the dentist’s level of education and adherence to the antibiotic prescription guidelines was not significant.

Conclusion There is inadequate adherence to the international guidelines among dental practitioners in dental clinics in primary healthcare centers in the National Guard. This irrational antibiotic prescribing accounts for the risk of antibiotic resistance, so there is a need to address antibiotic prescribing practices by increasing awareness among dental practitioners in these clinics.