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Toghroli R, Hassani L, Aghamolaei T, Sharma M, Sharifi H, Jajarmi M. Explaining the barriers faced by veterinarians against preventing antimicrobial resistance: an innovative interdisciplinary qualitative study. BMC Infect Dis 2024; 24:455. [PMID: 38689250 PMCID: PMC11059684 DOI: 10.1186/s12879-024-09352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Considering the significance of increased antimicrobial resistance (AMR) and its adverse effects on individual and social health and the important and effective role that veterinarians play in controlling this growing issue worldwide, it is essential to have effective preventive control programs. To this aim, the first step is to identify the factors behind the prevalence of AMR in Iran and the barriers veterinarians face to controlling this problem. Thus, the present study was conducted to explain the barriers veterinarians faced in the prevention of AMR from an Iranian veterinarian's perspective. METHODS The present research was done in three cities in Iran in 2021. The data were collected through in-depth interviews with 18 veterinarians selected through purposive and snowball sampling and analyzed using conventional qualitative content analysis. RESULTS The data analysis results were classified into 4 main categories and 44 subcategories. The former included: educational factors, administrative/legal factors, client-related factors, and veterinarian-related factors. CONCLUSIONS The increased AMR can be approached from multiple aspects. Considering the different factors that affect the increased AMR, it is necessary to consider them all through effective planning and policy-making at multi-level and multidisciplinary dimensions. There is special attention needed to scientific and practical interventions at the individual, interpersonal, social, and even political levels. At the same time, measures should be taken to rehabilitate and maintain the health of society to strengthen supervision and attract the full participation of interested organizations.
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Affiliation(s)
- Razie Toghroli
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Laleh Hassani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Teamur Aghamolaei
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas (UNLV), Las Vegas, NV, 89119, USA
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Maziar Jajarmi
- Department of Pathobiology, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
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Mathur MR, Nagrath D, Mishra VK, Harris R, Saeed SS, Selvaraj S, Mehta A, Farooqui HH. Antibiotic prescriptions for oral diseases in India: evidence from national prescription data. BMC Oral Health 2023; 23:170. [PMID: 36966284 PMCID: PMC10039494 DOI: 10.1186/s12903-023-02889-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 03/15/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION The key objective of this research was to describe the prescription rate of various antibiotics for dental problems in India and to study the relevance of the prescriptions by analysing antibiotic types associated with different dental diagnoses, using a large-scale nationally representative dataset. METHODS We used a 12-month period (May 2015 to April 2016) medical audit dataset from IQVIA (formerly IMS Health). We coded the dental diagnosis provided in the medical audit data to the International Statistical Classification of Diseases and Related Health Problems (ICD-11) and the prescribed antibiotics for the diagnosis to the Anatomic Therapeutic Chemical (ATC) -2020 classification of the World Health Organization. The primary outcome measure was the medicine prescription rate per 1,000 persons per year (PRPY1000). RESULTS Our main findings were-403 prescriptions per 1,000 persons per year in the year 2015 -2016 for all dental ailments. Across all ATC level 1 classification, 'Diseases of hard tissues' made up the majority of the prescriptions. 'Beta-lactam', 'Penicillin,' and 'Cephalosporins' were the most commonly prescribed antibiotics for dental diagnoses followed by 'Macrolides' and 'Quinolones'. 'Dental caries', 'Discoloration of tooth', and 'Toothache' were the most common reasons for 'Beta-Lactams' and 'Penicillin' prescriptions. CONCLUSION To conclude our study reports first ever country (India) level estimates of antibiotic prescription by antibiotic classes, age groups, and ICD-11 classification for dental ailments.
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Affiliation(s)
- Manu Raj Mathur
- Queen Mary University of London, Mile End Rd, Bethnal Green, London, E1 4NS, England.
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India.
| | - Deepti Nagrath
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
| | - Vijay Kumar Mishra
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
| | | | | | - Sakthivel Selvaraj
- Health Economics, Financing and Policy, Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
| | - Aashna Mehta
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
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Armas Freire PI, Gaspar GG, Zurita J, Salazar G, Velez JW, Bollela VR. E-Learning versus Face-to-Face Methodology for Learning Antimicrobial Resistance and Prescription Practice in a Tertiary Hospital of a Middle-Income Country. Antibiotics (Basel) 2022; 11:antibiotics11121829. [PMID: 36551486 PMCID: PMC9774894 DOI: 10.3390/antibiotics11121829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Antimicrobial resistance is a growing health problem worldwide. One strategy to face this problem in a reasonable way is training health personnel for the rational use of antimicrobials. There are some difficulties associated with medical staff to receiving training with E-learning education, but there is a lack of studies and insufficient evidence of the effectiveness of this method compared to face-to-face learning. Methods: An educational intervention on antimicrobial resistance (AMR) and antimicrobial prescription practice (APP) was designed and implemented using two approaches: face-to-face and E-learning among physicians of the intensive care unit (ICU) and internal medicine ward (IMW) at Eugenio Espejo Hospital in Quito. Modalities of interventions were compared to propose a strategy of continuous professional development (CPD) for all hospital staff. An interventional study was proposed using a quasi-experimental approach that included 91 physicians, of which 49 belong to the IMW and 42 to the ICU. All of them received training on AMR—half in a face-to-face mode and the other half in an asynchronous E-learning mode. They then all participated on APP training but with switched groups; those who previously participated in the face-to-face experience participated in an E-learning module and vice-versa. We evaluated self-perception about basic knowledge, attitudes and referred practices towards AMR and APP before and after the intervention. A review of medical records was conducted before and after training by checking antimicrobial prescriptions for all patients in the ICU and IMW with bacteremia, urinary tract infection (UTI), pneumonia, and skin and soft tissue infection. The study received IRB clearance, and we used SPSS for statistical analysis. Results: No statistically significant difference was observed between the E-learning and the face-to-face methodology for AMR and APP. Both methodologies improved knowledge, attitudes and referred practices. In the case of E-learning, there was a self-perception of improved attitudes (p < 0.05) and practices (p < 0.001) for both AMR and APP. In face-to-face, there was a perception of improvement only in attitudes (p < 0.001) for APP. In clinical practice, the use of antimicrobials significantly improved in all domains after training, including empirical and targeted treatment of bacteremia and pneumonia (p < 0.001) and targeted treatment of UTI (p < 0.05). For the empirical treatment of pneumonia, the mean number of antibiotics was reduced from 1.87 before to 1.05 after the intervention (p = 0.003), whereas in the targeted management of bacteremia, the number of antibiotics was reduced from 2.19 to 1.53 (p = 0.010). Conclusions: There was no statistically significant difference between the effect of E-learning and face-to-face strategy in terms of teaching AMR and APP. Adequate self-reported attitudes and practices in E-learning exceed those of the face-to-face approach. The empiric and targeted use of antimicrobials improved in all reviewed cases, and we observed an overall decrease in antibiotic use. Satisfaction with training was high for both methods, and participants valued the flexibility and accessibility of E-learning.
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Affiliation(s)
| | - Gilberto Gambero Gaspar
- Infection Control Service, University Hospital of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Jeannete Zurita
- Biomedical Research Unit, Zurita & Zurita Laboratories and Medical School, Pontifical Catholic University of Ecuador, Quito 170104, Ecuador
| | - Grace Salazar
- Infection Service, Oncologic Solca Hospital, Quito 170138, Ecuador
| | - Jorge Washington Velez
- Division of Education and Research, Hospital de Especialidades Eugenio Espejo, Central University of Ecuador, Quito 170136, Ecuador
| | - Valdes Roberto Bollela
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
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Griffith A, Mateen A, Markowitz K, Singer SR, Cugini C, Shimizu E, Wiedman GR, Kumar V. Alternative Antibiotics in Dentistry: Antimicrobial Peptides. Pharmaceutics 2022; 14:1679. [PMID: 36015305 PMCID: PMC9412702 DOI: 10.3390/pharmaceutics14081679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 01/12/2023] Open
Abstract
The rise of antibiotic resistant bacteria due to overuse and misuse of antibiotics in medicine and dentistry is a growing concern. New approaches are needed to combat antibiotic resistant (AR) bacterial infections. There are a number of methods available and in development to address AR infections. Dentists conventionally use chemicals such as chlorohexidine and calcium hydroxide to kill oral bacteria, with many groups recently developing more biocompatible antimicrobial peptides (AMPs) for use in the oral cavity. AMPs are promising candidates in the treatment of (oral) infections. Also known as host defense peptides, AMPs have been isolated from animals across all kingdoms of life and play an integral role in the innate immunity of both prokaryotic and eukaryotic organisms by responding to pathogens. Despite progress over the last four decades, there are only a few AMPs approved for clinical use. This review summarizes an Introduction to Oral Microbiome and Oral Infections, Traditional Antibiotics and Alternatives & Antimicrobial Peptides. There is a focus on cationic AMP characteristics and mechanisms of actions, and an overview of animal-derived natural and synthetic AMPs, as well as observed microbial resistance.
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Affiliation(s)
- Alexandra Griffith
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Akilah Mateen
- Department of Chemistry and Biochemistry, Seton Hall University, South Orange, NJ 07079, USA
| | - Kenneth Markowitz
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
| | - Steven R. Singer
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
| | - Carla Cugini
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
| | - Emi Shimizu
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
- Department of Endodontics, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
| | - Gregory R. Wiedman
- Department of Chemistry and Biochemistry, Seton Hall University, South Orange, NJ 07079, USA
| | - Vivek Kumar
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
- Department of Endodontics, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
- Department of Biology, New Jersey Institute of Technology, Newark, NJ 07102, USA
- Department of Chemical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
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Effect of an educational intervention among Lebanese dentists on antibiotic prescribing: a randomized controlled study. Clin Oral Investig 2022; 26:4857-4869. [DOI: 10.1007/s00784-022-04453-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/12/2022] [Indexed: 11/26/2022]
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Pisarnturakit PP, Sooampon S, Sooampon S. Managing knowledge for health care quality: An investigation of rational antibiotic use among Thai dentists. Int J Health Plann Manage 2019; 35:606-613. [PMID: 31755146 DOI: 10.1002/hpm.2971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/03/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Because of the irrational use of antibiotics, antimicrobial resistance is now a global concern that requires developing effective strategies against. The aim of this study was to assess the knowledge gap that causes the irrational use of antibiotics among Thai dentists. METHODS Thai dentists were asked to complete an online questionnaire regarding their knowledge, perception, and attitude towards rationale antibiotic use. The survey was conducted during November to December 2018. RESULTS Online questionnaires were completed by 588 dentists. Most respondents had a positive perception and were aware of the rational use of antibiotics. However, the use of antibiotics without proper indication and the lack of pharmacological knowledge were found. A mobile application was considered the most preferable approach to manage knowledge for rational drug use. CONCLUSION Irrational drug use among Thai dentists can be caused by lack of knowledge, attitude, and the perception of each dentist. Policy makers should promote self-learning through knowledge management strategies that can complement the pharmacology courses taught in dental school.
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Affiliation(s)
| | - Sireerat Sooampon
- Department of Pharmacology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sutti Sooampon
- Department of International Business Administration, Faculty of Administration and Management, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
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Löffler C, Böhmer F. The effect of interventions aiming to optimise the prescription of antibiotics in dental care-A systematic review. PLoS One 2017; 12:e0188061. [PMID: 29136646 PMCID: PMC5685629 DOI: 10.1371/journal.pone.0188061] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 10/31/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Abundant evidence in dentistry suggests that antibiotics are prescribed despite the existence of guidelines aiming to reduce the development of antibiotic resistance. This review investigated (1) which type of interventions aiming to optimise prescription of antibiotics exist in dentistry, (2) the effect of these interventions and (3) the specific strengths and limitations of the studies reporting on these interventions. METHOD Literature search was based on Medline, Embase, Global Health, Cochrane CENTRAL, ClinicalTrials.gov and Current Controlled Trials. Studies with one of the two primary outcomes were included: (1) The number of antibiotics prescribed and/or (2) the accuracy of the prescription, commonly measured as a percentage of adherence to local clinical guidelines. RESULTS Nine studies met these inclusion criteria. Five studies reported on the prescription of antibiotics in primary dental care and four studies focused on outpatient dental care. Interventions used in primary dental care included a combination of audit, feedback, education, local consensus, dissemination of guidelines and/or academic detailing. Trials in the outpatient setting made use of expert panel discussions, educational feedback on previous acts of prescribing, the dissemination of guidelines and the establishment of internal guidelines. All studies successfully reduced the number of antibiotics prescribed and/or increased the accuracy of the prescription. However, most studies were confounded by a high risk of selection bias, selective outcome reporting and high variance across study groups. In particular, information relating to study design and methodology was insufficient. Only three studies related the prescriptions to the number of patients treated with antibiotics. CONCLUSIONS This systematic review was able to offer conclusions which took the limitations of the investigated studies into account. Unfortunately, few studies could be included and many of these studies were confounded by a low quality of scientific reporting and lack of information regarding study methodology. High-quality research with objective and standardised outcome reporting, longer periods of follow-up, rigorous methodology and adequate standard of study reporting is urgently needed.
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Affiliation(s)
- Christin Löffler
- Institute of General Practice, Rostock University Medical Center, Rostock, Germany
| | - Femke Böhmer
- Institute of General Practice, Rostock University Medical Center, Rostock, Germany
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AlRahabi MK, Abuong ZA. Antibiotic abuse during endodontic treatment in private dental centers. Saudi Med J 2017; 38:852-856. [PMID: 28762439 PMCID: PMC5556303 DOI: 10.15537/smj.2017.8.19373] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 05/11/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES We evaluated antibiotic prescription practices during root canal treatments among general dentists in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia. Methods: A self-administered, questionnaire about antibiotic used during root canal treatment was distributed to 75 randomly selected general dental practitioners working in private dental clinics in Al-Madinah Al-Munawarah, Saudi Arabia, between March and April 2016. The questionnaires were collected one week later. To compare results of the collected data, Chi-square test was used. Results: The results revealed that 60% of the dentists prescribed amoxicillin with clavulanic acid as the first choice treatment for endodontic pathosis. Clindamycin (51.6%) was the first choice for patients who were allergic to penicillin. Forty-five percent of the general practitioners prescribed antibiotics for 5 days. Approximately 83.3% of general practitioners prescribed antibiotics for acute apical abscesses. Prophylactic antibiotics were prescribed for cases with a history of infective endocarditis (65.5%), non-controlled diabetes (60.3%), placement of a prosthetic joint in the previous 2 years (46.6%), congenital heart disease (36.2%), and kidney dialysis shunts (34.5%). Conclusion: This study reveals antibiotic abuse in endodontic treatment practice in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia. General dental practitioners are lacking knowledge regarding the prescription of antibiotics in endodontic treatment and situations requiring prophylactic antibiotics.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah AlMunawwarah, Kingdom of Saudi Arabia. E-mail.
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Khalil D, Hultin M, Andersson Fred L, Parkbring Olsson N, Lund B. Antibiotic prescription patterns among Swedish dentists working with dental implant surgery: adherence to recommendations. Clin Oral Implants Res 2014; 26:1064-9. [PMID: 24730684 DOI: 10.1111/clr.12402] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate antibiotic prophylaxis prescription behaviors among Swedish dentists working with dental implant surgery and the influence of scientific reviews. MATERIAL AND METHODS An observational questionnaire study was conducted in 2008 and 2012. Dental clinic addresses were found through online search services of Swedish telephone directories. The questionnaires were posted to eligible dentists (120 in 2008, 161 in 2012) in the Stockholm region, Sweden. Absolute frequencies were used to describe the data. Chi-square tests were applied to assess statistically significant differences. RESULTS The response rate was 75% in 2008 and 88% in 2012. In 2008, 88% of the dentists routinely prescribed antibiotic prophylaxis when performing implant surgery and 74% in 2012 (P = 0.01). There was a significant reduction in the dentists prescription patterns as 65% prescribed a single dose in 2012, compared to 49% in 2008 (P = 0.04). Amoxicillin was the drug of choice for 47% of the respondents in 2012, and 21% in 2008 (P = 0.01). Dentists without postgraduate clinical training were significantly more prone to extend antibiotic administration after surgery (P < 0.009). CONCLUSIONS There is a wide variation in the choice of compound and prescription patterns of prophylactic antibiotic prior to implant insertion. A reduction in antibiotic prescription to a single dose was observed comparing 2008 and 2012, probably influenced by scientific reviews. Dentists with postgraduate education are more likely to limit antibiotic usage.
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Affiliation(s)
- Dalia Khalil
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Margareta Hultin
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | | | | | - Bodil Lund
- Department of Dental Medicine, Division of Orofacial Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden.,Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
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Kaptan RF, Haznedaroglu F, Basturk FB, Kayahan MB. Treatment approaches and antibiotic use for emergency dental treatment in Turkey. Ther Clin Risk Manag 2013; 9:443-9. [PMID: 24307834 PMCID: PMC3845533 DOI: 10.2147/tcrm.s52009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to gather information about Turkish general dental practitioners’ treatment approaches towards endodontic emergencies, antibiotic-prescribing habits, and their participation in lifelong learning programs. Questionnaires were given to dentists who attended the 16th National Congress organized by the Turkish Dental Association. From 1,400 questionnaires distributed, 589 (43%) were deemed usable in this study. This survey dealt with questions that were subdivided into two main topics: dental emergency treatment approaches, and antibiotic prescription and information on lifelong learning program participation. The statistical analysis was conducted with a χ2 test at a significance level of P<0.05. For irreversible pulpitis cases in vital teeth, most of the dental practitioners (65.3%) preferred single-visit root canal treatments. For teeth presenting a periapical lesion, the preferred treatment approach was root canal treatment (91.5%). The rate of prescription of analgesics and antibiotics was 21.7% in untreated acute apical periodontitis cases and 41% in acute apical abscess cases. Frequently prescribed antibiotics were amoxicillin–clavulanate (61.8%) and amoxicillin (46.5%). There was a tendency for practitioners to attend congresses as their years of professional practice increased (P<0.0001). There have been discrepancies between taught and observed practice. Educational initiatives are needed to prevent inappropriate prescription of antibiotics.
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Antibiotic prescribing habits of dental surgeons in hyderabad city, India, for pulpal and periapical pathologies: a survey. Adv Pharmacol Sci 2013; 2013:537385. [PMID: 24187549 PMCID: PMC3804281 DOI: 10.1155/2013/537385] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 09/03/2013] [Indexed: 11/17/2022] Open
Abstract
Aim. To determine the antibiotic prescribing habits for pulpal and periapical pathology among dentists in Hyderabad city, India. Methodology. A total of 246 questionnaires were distributed to all the dentists registered with the local dental branch. Demographic details and questions regarding type and dosage of antibiotics prescribed for allergic and nonallergic patients were recorded. Inferential statistics were performed, and P < 0.05 was considered statistically significant. Results. The response rate for the study was 87.8%. Around 148 (68.5%) of respondents regularly prescribed antibiotics for endodontic management. The first antibiotic of choice for patients with no history of medical allergies was a combination of amoxicillin and metronidazole, followed by amoxicillin alone (29.1%). The first antibiotic of choice in case of allergy to penicillin was erythromycin. Necrotic pulp with acute apical periodontitis with swelling and moderate/severe preoperative symptom was the condition most commonly identified for antibiotic therapy (92.1%). Conclusion. The present study reveals that the overall antibiotic prescribing practices among this group of dentists were quite high, and there is a need for more educational initiatives to rationalize the use of antibiotics in dentistry.
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Al-Huwayrini L, Al-Furiji S, Al-Dhurgham R, Al-Shawaf M, Al-Muhaiza M. Knowledge of antibiotics among dentists in Riyadh private clinics. Saudi Dent J 2013; 25:119-24. [PMID: 24179321 DOI: 10.1016/j.sdentj.2013.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 04/01/2013] [Accepted: 05/22/2013] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Dentists prescribe antibiotics for both therapeutic and prophylactic reasons to manage oral and dental infections. Antibiotic prescriptions can be associated with unfavorable side effects and the development of resistance. AIM OF THE STUDY A survey was conducted among dental specialists (DSs) and general dental practitioners (GDPs) at private dental clinics in Riyadh, Saudi Arabia to assess their level of knowledge regarding the action of antibiotics, their use and misuse in oral conditions, systemic diseases and prophylaxis. SUBJECTS AND METHODS A total of 380 identical surveys that contained 32 questions were completed by DSs and GDPs in a supervised setting. Descriptive statistics were calculated to assess the overall knowledge of both DSs and GDPs, and their knowledge within each category of questions. Independent t-tests were used to ascertain whether there were significant differences between DSs and GDPs. A scatterplot diagram was used to test for a correlation between the years of experience of practitioners and their knowledge level. RESULT The response rate was 79.7%. An acceptable level of knowledge was attained by 85.5% of dentists and 42.2% just passed. The percentage of dentists with an acceptable level of knowledge regarding prophylaxis was 51%. The scores for overall information levels about antibiotics among both DSs and GDPs were close to 70%. The percentage of DSs with an acceptable level of knowledge on antibiotic actions was 69.2%, 90.7% for oral conditions and 66.7% for medical conditions, compared to 66.8%, 88.7% and 64.8%, respectively, for GDPs. No significant relationship was found between the experience and knowledge level. CONCLUSIONS Our findings suggest that the overall knowledge level of dentists about antibiotics is acceptable, but more focus should be given to their ongoing training regarding the pharmacological aspects, pertinent medical conditions and prophylactic use of antibiotics.
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Affiliation(s)
- Lujain Al-Huwayrini
- Medically Compromised Patients Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Dar-Odeh NS, Abu-Hammad OA, Al-Omiri MK, Khraisat AS, Shehabi AA. Antibiotic prescribing practices by dentists: a review. Ther Clin Risk Manag 2010; 6:301-6. [PMID: 20668712 PMCID: PMC2909496 DOI: 10.2147/tcrm.s9736] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Indexed: 01/04/2023] Open
Abstract
Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, due to a number of factors ranging from inadequate knowledge to social factors. Here we review studies that investigated the pattern of antibiotic use by dentists worldwide. The main defects in the knowledge of antibiotic prescribing are outlined. The main conclusion is that, unfortunately, the prescribing practices of dentists are inadequate and this is manifested by over-prescribing. Recommendations to improve antibiotic prescribing practices are presented in an attempt to curb the increasing incidence of antibiotic resistance and other side effects of antibiotic abuse.
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