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Bazsefidpay N, Holmqvist F, Khalil D, Wexell CL, Hultin M, Nilsson P, Lund B. Antibiotic prescription in bone augmentation and dental implant procedures: a multi-center study. BMC Oral Health 2023; 23:818. [PMID: 37899438 PMCID: PMC10613362 DOI: 10.1186/s12903-023-03534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/12/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Adherence to antibiotic recommendations and safety aspects of restrictive use are important components when combating antibiotic resistance. The primary aim of this study was to assess the impact of national guidelines on antibiotic prescriptions for bone augmentation procedures among dentists working at three specialized clinics. The secondary aim was to assess the occurrence of postoperative infections. METHODS Medical charts of 400 patients treated with bone augmentation were reviewed: 200 in the years 2010-2011 and 200 in 2014-2015. The Swedish national recommendations for antibiotic prophylaxis were published in 2012. RESULTS There was a wide variation in antibiotic regiments prescribed throughout the study. The number of patients treated with antibiotic prophylaxis in a single dose of 2 g amoxicillin, and treated as advocated in the national recommendations, was low and decreasing between the two time periods from 25% (n = 50/200) in 2010-2011 to 18.5% (n = 37/200) in 2014-2015. The number of patients not given any antibiotics either as a prophylactic single dose or during the postoperative phase increased (P < 0.001). The administration of a 3-7-days antibiotic prescription increased significantly from 25.5% in 2010-2011 to 35% in 2014-2015. The postoperative infection rates (4.5% and 6.5%) were without difference between the studied periods. Smoking and omitted antibiotic prophylaxis significantly increased the risk of postoperative infection. Logistic regression analyses showed that patient male gender and suffering from a disease were predictive factors for the clinician to adhere to the guidelines. CONCLUSIONS After introduction of national recommendations for antibiotic prophylaxis before bone augmentation procedures, the patient group receiving a single preoperative dose decreased while the group not given antibiotic prophylaxis increased. There was no difference in occurrence of postoperative infections between the two time periods. The results indicate a need for educational efforts and strategies for implementation of antibiotic prudence and awareness among surgeons performing bone augmentation procedures.
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Affiliation(s)
- Nikoo Bazsefidpay
- Head-neck and plastic surgery clinic, Department of Oral and Maxillofacial Surgery, Örebro University Hospital, Örebro, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Fredrik Holmqvist
- Department of Dental Medicine, Division of Orofacial Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden
- Department of Dental Medicine, Division of Oral and Maxillofacial Surgery, Jönköping, Sweden
| | - Dalia Khalil
- Department of Dentistry, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Cecilia Larsson Wexell
- Department of Oral and Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden
- Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, Malmö, Sweden
| | - Margareta Hultin
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Solna, Alfred Nobels allé 8, 141 04, Sweden
| | - Peter Nilsson
- Department of Dental Medicine, Division of Oral and Maxillofacial Surgery, Jönköping, Sweden
| | - Bodil Lund
- Department of Dental Medicine, Division of Orofacial Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden.
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Department for Oral and Maxillofacial Surgery and Jaw Orthopedics, Karolinska University Hospital, Stockholm, Sweden.
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Santamaría Arrieta G, Rodríguez Sánchez F, Rodriguez-Andrés C, Barbier L, Arteagoitia I. The effect of preoperative clindamycin in reducing early oral implant failure: a randomised placebo-controlled clinical trial. Clin Oral Investig 2023; 27:1113-1122. [PMID: 36098814 PMCID: PMC9469834 DOI: 10.1007/s00784-022-04701-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To assess the effect of preoperative oral clindamycin in reducing early implant failure in healthy adults undergoing conventional implant placement. MATERIALS AND METHODS We conducted a prospective, randomised, double-blind, placebo-controlled clinical trial in accordance with the ethical principles and Consolidated Standards of Reporting Trials statement. We included healthy adults who underwent a single oral implant without previous infection of the surgical bed or the need for bone grafting. They were randomly treated with a single dose of oral clindamycin (600 mg) 1 h before surgery or a placebo. All surgical procedures were performed by one surgeon. A single trained observer evaluated all patients on postoperative days 1, 7, 14, 28, and 56. Early dental implant failure was defined as the loss or removal of an implant for any reason. We recorded the clinical, radiological, and surgical variables, adverse events, and postoperative complications. The study outcomes were statistically analysed to evaluate differences between the groups. Furthermore, we calculated the number required to treat or harm (NNT/NNH). RESULTS Both the control group and clindamycin group had 31 patients each. Two implant failures occurred in the clindamycin group (NNH = 15, p = 0.246). Three patients had postoperative infections, namely two placebo-treated and one clindamycin-treated, which failed (relative risk: 0.5, CI: 0.05-5.23, absolute risk reduction = 0.03, confidence interval: - 0.07-0.13, NNT = 31, CI: 7.2-∞, and p = 0.5). One clindamycin-treated patient experienced gastrointestinal disturbances and diarrhoea. CONCLUSIONS Preoperative clindamycin administration during oral implant surgery in healthy adults may not reduce implant failure or post-surgical-complications. CLINICAL RELEVANCE Oral clindamycin is not efficacy. TRIAL REGISTRATION The present trial was registered (EudraCT number: 2017-002,168-42). It was approved by the Committee for the Ethics of Research with Medicines of Euskadi (CEIm-E) on 31 October 2018 (internal code number: 201862) and the Spanish Agency of Medicines and Medical Devices (AEMPS) on 18 December 2018.
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Affiliation(s)
- Gorka Santamaría Arrieta
- Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Fabio Rodríguez Sánchez
- Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven and University Hospitals Leuven, Louvain, Belgium
| | | | - Luis Barbier
- Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Iciar Arteagoitia
- Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain.
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.
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Hultin M, Lund B, Lundgren F, Cederlund A. Dental implant procedures contribution to the total antibiotic use in Swedish dentistry. A register-based study. Acta Odontol Scand 2023; 81:143-150. [PMID: 35802705 DOI: 10.1080/00016357.2022.2097306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To study the influence of demographic and organizational factors to antibiotic utilization in dental implant surgery in Sweden. MATERIAL AND METHODS Descriptive statistics regarding antibiotic prescription between 2009 and 2019 was retrieved from two national registers, the Swedish Prescribed Drug Register and the Dental Health register, both administered by the National Board of Health and Welfare. RESULTS During the years 2009-2019 a significant decrease of the proportion of prescriptions of systemic antibiotics in conjunction with implant surgical procedures occurred in all patient groups where the most common procedure was the insertion of a single implant. The proportion of dental visits when implant surgical treatment was performed which resulted in a prescription of antibiotics decreased significantly from 1/3 to approximately 1/5. However, comparing Public and Private dental care providers, the reduction was significantly greater in Public dental care. Patients with low level of education in urban regions, treated in Private dental clinics were more likely to receive antibiotics in conjunction to implant surgery compared to other groups. Phenoxymethylpenicillin is the most widely used substance in conjunction with implant surgery. CONCLUSION There is still room for improvement in reduction of antibiotic prescriptions in conjunction to implant surgical procedures in Sweden.
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Affiliation(s)
- Margareta Hultin
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Bodil Lund
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Department of Plastic Surgery and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Frida Lundgren
- The National Board of Health and Welfare, Stockholm, Sweden
| | - Andreas Cederlund
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Oral and Maxillofacial Radiology, Eastmaninstitutet, Folktandvården, Stockholm, Sweden.,Faculty of odontology, Malmö University, Malmö, Sweden
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George A, Narayan V, Joseph B, Balram B, Anil S. Antimicrobial prescription patterns among oral implantologists of Kerala, India: A cross-sectional survey. J Pharm Bioallied Sci 2022; 14:S712-S718. [PMID: 36110751 PMCID: PMC9469451 DOI: 10.4103/jpbs.jpbs_744_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/13/2022] [Accepted: 01/24/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives: Antimicrobial resistance is a grave public health concern, and it is important to optimize the use of antimicrobials in dental surgeries. Antimicrobial prescriptions in dental implant placements are often empiric and not guided by consensus or specific guidelines. The aim of this study was to elucidate antibiotic prescribing patterns among oral implantologists. The objectives were to identify the frequency of antimicrobial usage and preferences regarding the perioperative timing of prescriptions, type of antibiotic, dosage, and duration in different implant placement scenarios. Subjects and Methods: An anonymized web-based survey was carried out. Participants were drawn from the lists of oral implantologists from all local branches of the Indian Dental Association in the state of Kerala, India, until the required sample size was met. Responses were recorded using an Internet-based validated questionnaire sent via e-mail to the participants. The questionnaire contained five sections with both open-ended and closed-ended questions. Results: Among the 93 participants, 59% of the dental implantologists preferred 0.2% povidone-iodine as a preprocedural mouth rinse in the backdrop of the COVID-19 pandemic, and 68% prescribed 0.12%–0.2% chlorhexidine as the postoperative mouth rinse. The majority of the participants (73%) routinely prescribed systemic antibiotics perioperatively during implant placement surgery. Interestingly, while none of the participants preferred a solely preoperative regimen, 92.4% of the dentists in our survey prescribed both pre- and postoperative antibiotics. Antibiotics of choice as the preoperative agents were amoxicillin and amoxicillin plus clavulanic acid. The most preferred postoperative agent was amoxicillin plus clavulanic acid. The popularly reported rationale behind a preoperative antibiotic was to decrease or eliminate local or systemic infections (79%), and the majority of the participants (60%) prescribed postoperative antibiotics to prevent postoperative infection. Conclusions: Systemic antibiotic prescriptions in implant placement surgery are not based on currently available evidence. Most oral implantologists who participated in the survey prescribed systemic antibiotics to prevent perioperative infection, even in simple and straightforward implant placements. Specific guidelines need to be generated in complex implant placement situations and implant placement in medically compromised patients to prevent excessive prescriptions.
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Salgado-Peralvo AO, Kewalramani N, Peña-Cardelles JF, Mateos-Moreno MV, Monsalve-Guil L, Jiménez-Guerra Á, Ortiz-García I, Velasco-Ortega E. Preventive Antibiotic Prescribing Habits among Professionals Dedicated to Oral Implantology: An Observational Study. Antibiotics (Basel) 2021; 10:antibiotics10030301. [PMID: 33799411 PMCID: PMC7999193 DOI: 10.3390/antibiotics10030301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 12/11/2022] Open
Abstract
The prescription of preventive antibiotics (PA) in oral implantology is a controversial issue. The study aimed to determine the prescribing habits of PA in professionals dedicated to oral implantology in various treatments in healthy and at-risk patients. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 4 blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 303 participants (20.8%) responded to the questionnaire. One percent never prescribed PA, 55.4% prescribed them always, and 43.6% prescribed them sometimes. Ninety-six percent administered them preoperatively, while 92.4% administered them postoperatively. The most commonly used antibiotic is amoxicillin followed by amoxicillin with clavulanic acid (875/125 mg). Clindamycin is the most commonly administered antibiotic in patients with allergies. Professionals dedicated to oral implantology frequently prescribe PA in both healthy and at-risk patients, especially perioperatively. Immediate implant placement, sinus lifts, bone regeneration, and multiple implant placement are the treatments in which PA are most commonly prescribed, as well as in patients with heart valve prostheses or a history of bacterial endocarditis and immunodeficiency.
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Affiliation(s)
- Angel Orión Salgado-Peralvo
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
- Correspondence:
| | - Naresh Kewalramani
- Department of Nursery and Stomatology, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Juan Francisco Peña-Cardelles
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
- Department of Basic Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
| | - María Victoria Mateos-Moreno
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
- Department of Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Loreto Monsalve-Guil
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
| | - Álvaro Jiménez-Guerra
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
| | - Iván Ortiz-García
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
| | - Eugenio Velasco-Ortega
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
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Lodi G, Azzi L, Varoni EM, Pentenero M, Del Fabbro M, Carrassi A, Sardella A, Manfredi M. Antibiotics to prevent complications following tooth extractions. Cochrane Database Syst Rev 2021; 2:CD003811. [PMID: 33624847 PMCID: PMC8094158 DOI: 10.1002/14651858.cd003811.pub3] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The most frequent indications for tooth extractions, generally performed by general dental practitioners, are dental caries and periodontal infections. Systemic antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. This is an update of a review first published in 2012. OBJECTIVES To determine the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 16 April 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 3), MEDLINE Ovid (1946 to 16 April 2020), Embase Ovid (1980 to 16 April 2020), and LILACS (1982 to 16 April 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised, double-blind, placebo-controlled trials of systemic antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication. DATA COLLECTION AND ANALYSIS At least two review authors independently performed data extraction and 'Risk of bias' assessment for the included studies. We contacted trial authors for further details where these were unclear. For dichotomous outcomes, we calculated risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. For continuous outcomes, we used mean differences (MD) with 95% CI using random-effects models. We examined potential sources of heterogeneity. We assessed the certainty of the body of evidence for key outcomes as high, moderate, low, or very low, using the GRADE approach. MAIN RESULTS We included 23 trials that randomised approximately 3206 participants (2583 analysed) to prophylactic antibiotics or placebo. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, only one of the trials evaluated the role of antibiotic prophylaxis in groups of patients affected by those clinical conditions. We assessed 16 trials as being at high risk of bias, three at low risk, and four as unclear. Compared to placebo, antibiotics may reduce the risk of postsurgical infectious complications in patients undergoing third molar extractions by approximately 66% (RR 0.34, 95% CI 0.19 to 0.64; 1728 participants; 12 studies; low-certainty evidence), which means that 19 people (95% CI 15 to 34) need to be treated with antibiotics to prevent one infection following extraction of impacted wisdom teeth. Antibiotics may also reduce the risk of dry socket by 34% (RR 0.66, 95% CI 0.45 to 0.97; 1882 participants; 13 studies; low-certainty evidence), which means that 46 people (95% CI 29 to 62) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. The evidence for our other outcomes is uncertain: pain, whether measured dichotomously as presence or absence (RR 0.59, 95% CI 0.31 to 1.12; 675 participants; 3 studies) or continuously using a visual analogue scale (0-to-10-centimetre scale, where 0 is no pain) (MD -0.26, 95% CI -0.59 to 0.07; 422 participants; 4 studies); fever (RR 0.66, 95% CI 0.24 to 1.79; 475 participants; 4 studies); and adverse effects, which were mild and transient (RR 1.46, 95% CI 0.81 to 2.64; 1277 participants; 8 studies) (very low-certainty evidence). We found no clear evidence that the timing of antibiotic administration (preoperative, postoperative, or both) was important. The included studies enrolled a subset of patients undergoing dental extractions, that is healthy people who had surgical extraction of third molars. Consequently, the results of this review may not be generalisable to all people undergoing tooth extractions. AUTHORS' CONCLUSIONS The vast majority (21 out of 23) of the trials included in this review included only healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. None of the studies evaluated tooth extraction in immunocompromised patients. We found low-certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction when compared to placebo, and very low-certainty evidence of no increase in the risk of adverse effects. On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. It is unclear whether the evidence in this review is generalisable to patients with concomitant illnesses or patients at a higher risk of infection. Due to the increasing prevalence of bacteria that are resistant to antibiotic treatment, clinicians should evaluate if and when to prescribe prophylactic antibiotic therapy before a dental extraction for each patient on the basis of the patient's clinical conditions (healthy or affected by systemic pathology) and level of risk from infective complications. Immunocompromised patients, in particular, need an individualised approach in consultation with their treating medical specialist.
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Affiliation(s)
- Giovanni Lodi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Lorenzo Azzi
- Department of Medicine and Surgery, Unit of Oral Medicine and Pathology, University of Insubria, Varese, Italy
| | - Elena Maria Varoni
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy
| | - Monica Pentenero
- Dept. of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Orbassano, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Antonio Carrassi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy
| | - Andrea Sardella
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy
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Bernabeu-Mira JC, Peñarrocha-Diago M, Peñarrocha-Oltra D. Prescription of Antibiotic Prophylaxis for Dental Implant Surgery in Healthy Patients: A Systematic Review of Survey-Based Studies. Front Pharmacol 2021; 11:588333. [PMID: 33643035 PMCID: PMC7902906 DOI: 10.3389/fphar.2020.588333] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/12/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Systemic antibiotic prophylaxis is frequently prescribed by dentists performing dental implant surgery to avoid premature implant failure and postoperative infections. The scientific literature suggests that a single preoperative dose suffices to reduce the risk of early dental implant failure in healthy patients. Material and Methods: A systematic review was made based on an electronic literature search in the PubMed-Medline, Embase, Web of Science, Scopus and Open Gray databases. The review addressed the question: "which antibiotic prophylaxis regimens are being used in dental implant surgery in healthy patients according to survey-based studies?" The identification, screening, eligibility and inclusion phases were conducted according to the PRISMA statement by two independent reviewers. The following data were collected: country, number of surveyed dentists, number of dentists who responded (n), response rate, routine prescription of antibiotic prophylactic treatment (yes, no, or conditioned prescription), prescription regimen (preoperative, perioperative or postoperative) and antibiotic choice (first and second choice). Cohen's kappa coefficient (k) evaluated the level of agreement between the two reviewers. The analysis of risk of bias was performed follow the Joanna Briggs Institute checklist for observational studies. A descriptive statistical analysis was performed to calculate total target sample, sample size and total mean. Results: A total of 159 articles were identified, of which 12 were included in the analysis. Two thousand and seventy-seven dentists from nine different countries on three continents were surveyed. The median response rate was low and disparate between studies. About three-quarters of the surveyed dentists claimed to routinely prescribe systemic antibiotic prophylaxis for dental implant surgery. The prescription regimen was perioperative, postoperative and preoperative, in decreasing order of frequency. The most frequent first choice drug was amoxicillin, with amoxicillin-clavulanic acid as second choice. Conclusions: A majority of dentists from different countries do not prescribe systemic antibiotic prophylaxis for dental implant surgery following the available scientific evidence and could be overprescribing. Efforts are needed by dental educators and professionals to reduce the gap between the use of antibiotic prophylaxis for dental implant surgery as supported by the scientific evidence and what is being done by clinicians in actual practice.
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Affiliation(s)
- Juan Carlos Bernabeu-Mira
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - David Peñarrocha-Oltra
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Antibiotic prophylaxis during dental implant placement in the UK. Br Dent J 2020; 229:787-792. [PMID: 33339929 DOI: 10.1038/s41415-020-2352-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/09/2020] [Indexed: 11/08/2022]
Abstract
Background Antimicrobial resistance is a growing concern globally. It has previously been demonstrated that antibiotic prescribing for dental implants within the UK is varied with an apparent lack of guidance. This study aimed to establish current use of antibiotic prophylaxis during dental implant placements in the UK.Method An anonymous validated online questionnaire was distributed to members of the BAOS, BSSPD, BSP, ADI and ITI. Data were then collated and analysed.Results Two hundred and twenty-nine responses were received during April-July 2018. Fifty-five percent of dentists routinely prescribed antibiotics during implant placements. One-third did sometimes, but not routinely. Thirteen percent never prescribed. Reported protocols contained 61 different drug/dose combinations given over 124 different regimens. Those who prescribed routinely had significantly higher levels of training/qualification (P = 0.008), placed more implants (P = 0.014) and undertook more complex placements (P = 0.002) than non-prescribers. Seventy-three percent believed antibiotics decrease post-operative infection. One in ten felt they gave no benefit. Half believed they decrease implant failure. Over 90% would like national guidelines.Conclusion Significant variance in practice is clear. Almost half of practitioners did not routinely prescribe. Those who did were significantly more experienced, highly trained and did more complex placements. There was a difference between practitioners' perceived benefits of antibiotic prophylaxis and the evidence in the literature. There was a great desire for clearer guidance.
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Rodríguez Sánchez F, Arteagoitia I, Teughels W, Rodríguez Andrés C, Quirynen M. Antibiotic dosage prescribed in oral implant surgery: A meta-analysis of cross-sectional surveys. PLoS One 2020; 15:e0236981. [PMID: 32810135 PMCID: PMC7446810 DOI: 10.1371/journal.pone.0236981] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/18/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to assess the dosage and types of antibiotics prescribed in oral implant surgery, compare them among the different subpopulations (country and prescription regimens) and against the evidence-based recommended dosage: a 2-gram single preoperative dose of amoxicillin. A meta-analysis of cross-sectional surveys was conducted, which reports the overall dosage (and type) of antibiotics prescribed in combination with implant placement. PubMed, Cochrane, Science, Direct, and EMBASE via OVID were searched until April 2019. Three reviewers independently undertook data extraction and risk of bias assessment. The outcome variable was set on the average of prophylactic antibiotics prescribed per oral implant surgery. Overall, 726 participants from five cross-sectional surveys, representing five different countries were finally included. Amoxicillin was the most prescribed antibiotic. On average, 10,724 mg of antibiotics were prescribed per implant surgery. This average was significantly (p<0.001) higher than 2,000 mg. Overall, amoxicillin doses were significantly higher than 2,000 mg (9,700 mg, p<0.001). All prescribed amoxicillin regimens independently contained more than 2,000 mg, including those comprising only preoperative amoxicillin (2,175 mg, p = 0.006). Exclusive preoperative antibiotic regimens were the only subgroup with prescription dosages below this threshold (p = 0.091). Significant variations in antibiotic prescriptions were found among different countries and antibiotic regimens (p<0.001). In conclusion, the average dose of antibiotics prescribed per oral implant surgery was larger than the evidence-based recommended dose in healthy patients and straightforward conditions. In addition, variations in the average antibiotic dosages were found among different countries and prescription regimens.
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Affiliation(s)
- Fabio Rodríguez Sánchez
- Department of Preventive Medicine and Public Health, University of the Basque Country, Bilbao, Spain
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium
- * E-mail:
| | - Iciar Arteagoitia
- Department of Stomatology, University of the Basque Country, Bilbao, Spain
- Bioruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - Wim Teughels
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium
| | - Carlos Rodríguez Andrés
- Department of Preventive Medicine and Public Health, University of the Basque Country, Bilbao, Spain
| | - Marc Quirynen
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium
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Discrepancy in Therapeutic and Prophylactic Antibiotic Prescribing in General Dentists and Maxillofacial Specialists in Australia. Antibiotics (Basel) 2020; 9:antibiotics9080492. [PMID: 32784644 PMCID: PMC7459474 DOI: 10.3390/antibiotics9080492] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/29/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023] Open
Abstract
There are concerns that general dentists (GDs) and dental specialists may be prescribing antibiotics inappropriately. This study explored the prescribing habits and decision-making processes of GDs versus oral and maxillofacial surgeons (OMFSs). A case-based online questionnaire was used to examine the prescribing of therapeutic and prophylactic antibiotics in two clinical scenarios. Stratified and systematic sampling strategies were implemented to provide a representative sample. The final valid sample was 60 GDs and 18 OMFSs. The majority of OMFSs (61.1%) routinely prescribed antibiotics for the surgical removal of third molars, which was significantly greater than for GDs (23.5%). For implant placement procedures, 72.2% of OMFSs and 62.1% of GDs prescribed antibiotics. Amoxicillin was the most selected agent for both scenarios. All OMFSs would prescribe antibiotic prophylaxis for patients with uncontrolled diabetes mellitus in both cases, but only 56.0–63.0% of GDs would do this. GDs based prescribing decisions primarily on information from prescribing guides, while OMFSs relied more on information gained from specialist training. Surgical prophylaxis protocols differed considerably between groups. Both groups used surgical prophylaxis for some situations that are outside current recommendations. Education with regards to discrepancies between clinical practice and current guidelines for antimicrobial therapy is needed to progress antimicrobial stewardship.
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Antimicrobial Prescription Habits of Dentists Performing Dental Implant Treatments in Santo Domingo, Dominican Republic. Antibiotics (Basel) 2020; 9:antibiotics9070376. [PMID: 32635270 PMCID: PMC7399993 DOI: 10.3390/antibiotics9070376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/13/2020] [Accepted: 07/02/2020] [Indexed: 12/17/2022] Open
Abstract
The use of antibiotics in implant treatments is controversial. The purpose of this research was to study the behaviors of Santo Domingo dentists who prescribe antimicrobials to patients for the placement of dental implants. A total of 99 dentists participated in the study. A share of 1.2% of dentists prescribed antimicrobials solely in the preoperative period, 8.6% after surgery, 44.4% before and after, 19.8% only in specific situations, and 25.9% did not prescribe at all. Amoxicillin was the predominant antimicrobial of choice. A cross-sectional, observational, survey-based study was conducted. The items studied were demographics, self-assessment of knowledge about antibiotics and when they are used, as well as their recommended dosage and duration, in healthy and non-allergic patients. Notable variability was found in the prescription behaviors of antimicrobials. Bridging gaps in knowledge on the subject could help to standardize prescription guidelines.
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Barone A, Chatelain S, Derchi G, Di Spirito F, Martuscelli R, Porzio M, Sbordone L. Antibiotic's effectiveness after erupted tooth extractions: A retrospective study. Oral Dis 2020; 26:967-973. [PMID: 32027441 DOI: 10.1111/odi.13297] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/10/2020] [Accepted: 01/31/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The purpose of this retrospective study was to assess the influence of antibiotics on the development of alveolitis after tooth extractions. MATERIALS AND METHODS The study population consisted of patients who had erupted tooth extractions in 3 centers. The patients' medical records were collected for several parameters. Moreover, use of antibiotics was evaluated. The primary outcome was the development of alveolitis during the postoperative period. The secondary outcome measure was the possible associations between alveolitis and other patients' characteristics. RESULTS A total of 1579 patient charts were screened. The patients enrolled in the study were 418 (159 males and 259 females). Alveolitis was reported for 12 extraction sites (2.87%). Six were in the group of patients that received antibiotics (2.14% out of 280 patients treated with antibiotics), and six were in the group of patients that did not receive antibiotics (4.35% out of 138 patients not receiving antibiotics). None of patient-level parameters showed any significant association with the development of alveolitis. CONCLUSION In conclusion, this study showed that the use of antibiotics after erupted tooth extractions is not useful in preventing alveolitis. Larger, prospective, and randomized studies are needed before incorporating these findings into the daily clinical practice.
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Affiliation(s)
- Antonio Barone
- Department of Surgical, Medical and Molecular Pathologies and of the Critical Area, School of Dental Medicine, University-Hospital of Pisa, Pisa, Italy.,Unit of Oral Surgery and Implantology, School of Dental Medicine, University-Hospitals of Geneva, Geneva, Switzerland
| | - Sibylle Chatelain
- Specialist in Oral Surgery and Implantology, Unit of Oral Surgery, Maxillofacial Surgery and Oral Medicine, University Hospitals of Vaud, Lausanne, Switzerland
| | - Giacomo Derchi
- Unit of Oral Surgery and Stomatology, Department of Surgical, Medical and Molecular Pathologies and of the Critical Area, School of Dental Medicine, University-Hospital of Pisa, Pisa, Italy
| | - Federica Di Spirito
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", School of Dentistry, University of Salerno, Salerno, Italy.,Complex Operating Unit of Odontostomatology, Head and Neck Clinical Department, Azienda Ospedaliero-Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Ranieri Martuscelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Unit of Oro-Maxillofacial Oncology (UOC Maxillofacial Surgery) Clinical Department of Head and Neck (Chairman: Prof L.Califano), University of Naples "Federico II", Napoli, Italy
| | - Massimo Porzio
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", School of Dentistry, University of Salerno, Salerno, Italy.,Complex Operating Unit of Odontostomatology, Head and Neck Clinical Department, Azienda Ospedaliero-Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Ludovico Sbordone
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", School of Dentistry, University of Salerno, Salerno, Italy.,Complex Operating Unit of Odontostomatology, Head and Neck Clinical Department, Azienda Ospedaliero-Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
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Klinge A, Khalil D, Klinge B, Lund B, Naimi-Akbar A, Tranaeus S, Hultin M. Prophylactic antibiotics for staged bone augmentation in implant dentistry. Acta Odontol Scand 2020; 78:64-73. [PMID: 31483177 DOI: 10.1080/00016357.2019.1656819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: The objective of the study was to assess the effect of prophylactic antibiotics on the outcome of bone augmentation and subsequent dental implant placement by combining the recommended quality assessment methods for systematic reviews and primary studies.Materials and methods: This is a complex systematic review in which systematic reviews as well as primary studies are scrutinised. A search of Medline (OVID), The Cochrane Library (Wiley) and EMBASE, PubMed and Health technology assessment (HTA) organisations as-well as a complementary hand-search was carried out. Selected primary studies were assessed using GRADE. Each study was reviewed by three authors independently.Results: Abstract screening yielded six potential systematic reviews allocated for full-text inspection. A total of ten primary studies were read in full-text. No relevant systematic reviews regarding the topic of this article were found. The quality assessment resulted in two primary studies with a moderate risk of bias. Of the two studies with a moderate risk of bias, one compared a single dose of clindamycin 600 mg preoperatively with the same preoperative dose followed by four doses of 300 mg every 6 h. The second study compared a single dose prophylaxis of two different types of antibiotic compounds.Conclusion: In conclusion, the scientific evidence regarding the use of antibiotic prophylaxis for reducing the risk of infection in conjunction with bone augmentation procedures during dental implant placement is very limited. The infection rate as compared to nonusage of prophylactic antibiotics, selection of the most suitable compound, and the optimal duration of prophylactic treatment is still unknown.
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Affiliation(s)
- Anna Klinge
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, Malmö, Sweden
| | - Dalia Khalil
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden
| | - Björn Klinge
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden
- Department of Periodontology, Malmö University, Malmö, Sweden
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
| | - Bodil Lund
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Aron Naimi-Akbar
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sofia Tranaeus
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
- Department of Dental Medicine, Division of Cariology, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Hultin
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden
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Rodríguez Sánchez F, Arteagoitia I, Rodríguez Andrés C, Bruers J. Antibiotic prophylaxis prescribing habits in oral implant surgery in the Netherlands: a cross-sectional survey. BMC Oral Health 2019; 19:281. [PMID: 31830979 PMCID: PMC6909651 DOI: 10.1186/s12903-019-0981-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 12/03/2019] [Indexed: 12/18/2022] Open
Abstract
Background There seems to be no consensus on the prescription of prophylactic antibiotics in oral implant surgery. The Dutch Association of Oral Implantology (NVOI) guidelines do not include a clear policy on prophylactic antibiotic prescriptions for oral implant surgery among healthy patients. The purpose of the study was to determine whether antibiotic prophylaxis is commonly prescribed in the Netherlands by general dentists, maxillofacial surgeons and oral implantologists in conjunction with oral implant surgery among healthy patients and to assess the type and amount of prophylactic antibiotic prescribed. Methods This observational cross-sectional study is based on a web survey. A questionnaire developed in the United States of America was translated and slightly adjusted for use in the Netherlands. It contained predominantly close-ended questions relating to demographics, qualifications, antibiotic type, prescription duration and dosage. An email including an introduction to the study and an individual link to the questionnaire was sent in February 2018 to a sample of 600 general dental practitioners and all 302 specialized dentists (oral implantologists, periodontists and maxillofacial surgeons) recognized by the NVOI. Overall, 902 questionnaires were anonymously sent. Finally, 874 potential participants were reached. Collected data were analyzed through descriptive statistics. Results In total, 218 (24.9%) participants responded to the questionnaire, including 45 females (20.8%) and 171 males (79.2%). Overall, 151 (69.9%) regularly placed oral implants. Of them, 79 (52.7%) prescribe antibiotics only in specific situations, 66 (43.7%) regularly, and 5 (3.3%) did not prescribe antibiotics at all. Overall, 83 participants who prescribe antibiotics did so both pre- and postoperatively (57.2%), 47 only preoperatively (32.4%) and 12 exclusively postoperatively (8.3%). A single dose of 2000 mg of amoxicillin orally one hour prior to surgery was the most prescribed preoperative regimen. The most frequently prescribed postoperative regimen was 500 mg of amoxicillin three times daily for five days after surgery. On average, participants prescribe a total of 7018 mg of antibiotics before, during or after oral implant surgery. Conclusions Antibiotic prophylaxis in conjunction with oral implant surgery is prescribed in the Netherlands on a large scale, and recommendations based on the last published evidence are frequently not followed.
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Affiliation(s)
- Fabio Rodríguez Sánchez
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Barrio Sarriena, s/n, Lejona, 48940, Bilbao, Spain. .,Department of Oral Health Sciences, Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium.
| | - Iciar Arteagoitia
- Department of Stomatology, University of the Basque Country (UPV/EHU), Bilbao, Spain.,BioCruces Health Research Institute member, Cruces University Hospital, Barakaldo, Spain
| | - Carlos Rodríguez Andrés
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Barrio Sarriena, s/n, Lejona, 48940, Bilbao, Spain
| | - Josef Bruers
- Department of Social Dentistry and Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands.,Royal Dutch Dental Association (KNMT), Utrecht, the Netherlands
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Antibiotic prophylaxis habits in oral implant surgery among dentists in Italy: a cross-sectional survey. BMC Oral Health 2019; 19:265. [PMID: 31791306 PMCID: PMC6889412 DOI: 10.1186/s12903-019-0943-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The prescription of prophylactic antibiotics in conjunction with oral implant surgery remains inconsistent among different populations of dentists. The main objective of this study was to assess the current antibiotic prescribing habits of dentist in conjunction with oral implant surgery in Italy. The secondary objective was to assess the nature and amount (mg) of antibiotics prescriptions in order to evaluate whether any consensus has been reached and if the current recommendations are complied. METHODS Observational cross-sectional study based on a web-survey reported according to the STROBE guidelines. A questionnaire was sent via email to each registered member of the Italian Academy of Osseointegration (n = 400). The email included a link to the anonym web questionnaire developed on www.encuestafacil.com. It contained close-ended and some open-ended questions concerning demographics, antibiotic type, prescription duration and dosage. Collected data were analyzed using STATA® 14 software. RESULTS 160 participants responded the survey (response rate = 40%). Approximately 84% routinely prescribed prophylactic antibiotics in conjunction with oral implant surgery, 15.6% prescribed antibiotics in certain situations and only 1 did not prescribe antibiotics at all. Overall, 116 respondents prescribed both pre- and postoperative antibiotics, 29 prescribed antibiotics only preoperatively and 14 prescribed antibiotics exclusively after surgery. Italian dentists prescribed an average amount of 10,331 mg antibiotics before, during or after oral implant surgery. Approximately, only 17% (n = 27) of the participants who prescribed antibiotics before oral implant surgery complied with the recommendations proposed by the latest publications (no more than 3 g of preoperative amoxicillin before oral implant surgery). CONCLUSIONS Dentists in Italy on a large scale prescribe antibiotic prophylaxis in conjunction with oral implant surgery among healthy patients. A high range of prophylactic regimens is prescribed and they are not adhering to the new science-based specifications. Guidelines focused on the indications for prophylactic antibiotics among healthy patients are required to prevent bacterial resistance, side effects and costs caused by overtreatment and the irrational use of antibiotics.
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Stein K, Farmer J, Singhal S, Marra F, Sutherland S, Quiñonez C. The use and misuse of antibiotics in dentistry: A scoping review. J Am Dent Assoc 2019; 149:869-884.e5. [PMID: 30261952 DOI: 10.1016/j.adaj.2018.05.034] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/10/2018] [Accepted: 05/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND To describe antibiotic prescribing behaviors in dentistry, including clinical and nonclinical indications for their use, the type and regimen of antibiotics prescribed, and factors influencing their prescription, the authors conducted a scoping review. TYPES OF STUDIES REVIEWED The authors conducted a scoping review of published literature by searching multiple databases. Key search terms included dentist, antibiotic, antimicrobial, antibacterial, prophylaxis, prescription, pattern, habit, knowledge, and practice. Two authors independently reviewed titles and abstracts by using detailed eligibility criteria. The authors placed no restrictions on study design or publication year. The authors qualitatively assessed studies by using a modified version of the Center for Evidence-Based Management's critical appraisal of a survey checklist. RESULTS The authors identified 1,912 studies but considered only 118 studies eligible for review. Most included studies were either cross-sectional surveys (81 studies) or prescription audits (25 studies) from various geographic locations. Publication dates ranged from 1982 through 2017. The authors examined prophylactic and therapeutic antibiotic use in 48 and 29 studies, respectively. Another 29 studies examined the use of both prophylactic and therapeutic antibiotics in dentistry. Overall, dentists prescribed a wide variety of antibiotic regimens for various clinical and nonclinical indications. Dentists have acquired their prescribing knowledge from a variety of sources and have changed their antibiotic prescribing practices throughout their careers for various reasons. CONCLUSIONS AND PRACTICAL IMPLICATIONS Considering the seriousness of antibiotic resistance, the authors highlight trends in antibiotic prescribing practices, characterize factors contributing to the use and misuse of antibiotics in dentistry, provide insight into the importance of antibiotic stewardship in the oral health setting, and encourage dentists to reflect on their antibiotic prescription practices.
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Al-Kattan R, Al-Shibani N. Current trends in antibiotic prescription behavior among Saudi dentists performing implant surgery: A cross-sectional observational study. ACTA ACUST UNITED AC 2018; 10:e12383. [PMID: 30556379 DOI: 10.1111/jicd.12383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022]
Abstract
AIM The aim of the present study was to investigate current trends in antibiotic prescription behavior among dentists performing implant surgery. METHODS A cross-sectional observational study was conducted among 133 dental specialists in Saudi Arabia. A self-administered questionnaire comprising of 21 questions related to basic demographic details (ie, sex, age, nationality, undergraduate training, type of specialty, clinical, and implant practice experience) made up the first part of the questionnaire. The second part of the questionnaire consisted of 12 close-ended questions concerning knowledge and opinions of the dental specialists related to antibiotic prescription patterns pre- or post-implant surgeries. Data were compiled and analyzed using SPSS version 20. Descriptive statistics were employed to calculate the means and percentages for demographic data and preoperative and postoperative antibiotic-prescribing habits in dental implant placement. RESULTS All practicing dentists prescribed antibiotics preoperatively prior to routine dental implant placement; 41.4% (N = 55) of participants were in favor of recommending antibiotics after routine dental implant placement (postoperatively). CONCLUSION Antibiotic-prescribing patterns in implant surgery among Saudi dentists are diverse and inconsistent. Further studies are required to investigate the effect of prophylactic antibiotics in lowering the risk of implant failure.
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Affiliation(s)
- Reem Al-Kattan
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nouf Al-Shibani
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
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Arteagoitia I, Rodríguez-Andrés C, Rodríguez-Sánchez F. Antibiotic prophylaxis habits in dental implant surgery among dentists in Spain. A cross-sectional survey. Med Oral Patol Oral Cir Bucal 2018; 23:e608-e618. [PMID: 30148475 PMCID: PMC6167099 DOI: 10.4317/medoral.22626] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/19/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The use of antibiotics to prevent dental implant failures and postoperative infections remains a controversial issue. The objectives of this study were to assess the current antibiotic prescribing patterns and antibiotic prescribing frequency of dentists in Biscay (Spain) in conjunction with routine dental implant surgery among healthy patients and to determine whether any consensus has been reached by such practitioners and last published evidence was being followed. MATERIAL AND METHODS Observational cross-sectional study: electronic survey. This study was reported according to the STROBE guidelines. This anonymous questionnaire contained open-ended and close-ended questions. An email was sent 26 October 2017 to all the registered members of the Biscay dentists' College (n=989). The collected data were analyzed using STATA® 14 software, and 95% confidence intervals (CI) were used to assess the frequency of prescription for each antibiotic regimen. RESULTS The survey was responded to by a total of 233 participants (response rate=23.56%). Overall, 210 participants finished the survey completely, and 23 surveys were answered partially. The questionnaire was responded to by 122 females (58.1%) and 88 males (41.9%). Of the participants, 88% (n=207) always routinely prescribed prophylactic antibiotics in conjunction with dental implant surgery (95% CI: 84.79-92.88%). Approximately 9% (n=22) prescribed antibiotics sometimes (95% CI: 5.68-13.19%), and only 4 dentists (1.72%) never prescribed antibiotics (95% CI: 0.04-3.38%). Overall, 179 of 233 respondents prescribed both pre- and postoperative antibiotics (78.85%, 95% CI: 72.96-83.97%), 13 prescribed antibiotics only preoperatively (5.73%, 95% CI: 3.08-9.59%), and 35 prescribed antibiotics exclusively after routine dental implant surgery (15.42%, 95% CI: 10.98-20.78%). CONCLUSIONS Most of the dentists working in Biscay routinely prescribe prophylactic antibiotics in conjunction with dental implant surgery among healthy patients. A large range of prophylactic regimens are prescribed and the most recently published evidence is not being followed.
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Pattern of Antibiotic Prescription for Oral Implant Treatment Among Dentists in Saudi Arabia. IMPLANT DENT 2018; 27:317-323. [DOI: 10.1097/id.0000000000000748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park J, Tennant M, Walsh LJ, Kruger E. Is there a consensus on antibiotic usage for dental implant placement in healthy patients? Aust Dent J 2017; 63:25-33. [PMID: 28543332 DOI: 10.1111/adj.12535] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 11/30/2022]
Abstract
This systematic review aimed to determine whether there is consensus for antibiotic prescription in healthy patients undergoing implant placement. A search of PubMed, Embase and Medline databases was conducted in January 2016 to find published journal articles on the use of antibiotics in implant placement, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were prospective human clinical trials investigating antibiotic usage during implant placement. Fifteen studies were deemed suitable. In 13 studies, no statistical difference was found between antibiotic use and the incidence of prosthetic failure, implant failure and early postoperative infections. These were rated as having low to high risk bias. Contrary results were reported in two studies, both of which were rated as having a high potential for bias. In conclusion, antibiotic use in healthy patients for the prophylaxis of surgical infection associated with dental implant placement does not appear to improve clinical outcomes. Practitioners should apply principles of antimicrobial stewardship and not use antibiotics as a routine measure in healthy patients.
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Affiliation(s)
- J Park
- School of Dentistry, The University of Western Australia, Perth, Western Australia, Australia
| | - M Tennant
- Department of Anatomy, Physiology and Human Biology, International Research Collaborative, Oral Health and Equity, The University of Western Australia, Perth, Western Australia, Australia
| | - L J Walsh
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - E Kruger
- Department of Anatomy, Physiology and Human Biology, International Research Collaborative, Oral Health and Equity, The University of Western Australia, Perth, Western Australia, Australia
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Reddy CM, Brock AW, Coleman BG, Erley KJ, Johnson TM. Should Perioperative Antibiotics Be Prescribed Prophylactically for Uncomplicated Single Implant Surgeries? Clin Adv Periodontics 2017. [DOI: 10.1902/cap.2017.160040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Caitlin M. Reddy
- United States Army Advanced Education Program in Periodontics, Fort Gordon, GA
| | - Adam W. Brock
- United States Army Advanced Education Program in Periodontics, Fort Gordon, GA
| | - Brandon G. Coleman
- United States Army Advanced Education Program in Periodontics, Fort Gordon, GA
| | - Kenneth J. Erley
- United States Army Advanced Education Program in Periodontics, Fort Gordon, GA
| | - Thomas M. Johnson
- United States Army Advanced Education Program in Periodontics, Fort Gordon, GA
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Sarzi Amadè D, Cristalli M, Farronato G, Gallina G, Gambarini G, Laino G, Polimeni A, Santoro R, Malagola C. Modulo sperimentale di registrazione delle procedure diagnostiche e terapeutiche in ambito odontostomatologico. DENTAL CADMOS 2016. [DOI: 10.1016/s0011-8524(16)30025-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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