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Vázquez-Cancela O, Zapata-Cachafeiro M, Herdeiro MT, Figueiras A, Rodríguez-Fernández A. Dentists' knowledge, attitudes and perceptions of antibiotic prescribing: A systematic review. Prev Med 2024; 185:108043. [PMID: 38901743 DOI: 10.1016/j.ypmed.2024.108043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/08/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use. METHODS We conducted a systematic review of dentists' knowledge, attitudes and perceptions regarding antibiotic use, by searching the MEDLINE, EMBASE and Web of Science for all original paper published from January 1990 to July 2023, in accordance with the Preferred Reporting Items for systematic Reviews and Meta-analyses (PRISMA 2020) guidelines. RESULTS The review included 37 papers, (7 qualitative and 30 quantitative studies). Modifiable factors (knowledge, attitudes) were reported as being associated with antibiotic prescribing by dentists which were cited in 30 of the 37. These attitudes most frequently identified by dentists were: complacency (22/29); lack of trust (16/29); the need to postpone the dental procedure (17/29); and fear (8/29). Gaps in knowledge were also identified (15/29). Only one of the included articles quantified the influence between the reported modifiable factors and antibiotic prescribing. CONCLUSIONS The review emphasizes that dentists' antibiotic prescribing is predominantly influenced by modifiable factors. This insight informs the potential for targeted interventions to curtail inappropriate antibiotic use, contributing to global efforts in reducing antibiotic resistance. The protocol of this systematic review can be found in PROSPERO under registration no. CRD42021253937.
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Affiliation(s)
- Olalla Vázquez-Cancela
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
| | - Almudena Rodríguez-Fernández
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
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Almutairi W, Alrasheed AS, Alaglan YK, Aleyeoni S, Almogbel A. A Pharmacy-Based Cross-Sectional Study to Assess the Antibiotic Prescription Pattern by Medical and Dental Practitioners in Saudi Arabia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1598-S1600. [PMID: 38882843 PMCID: PMC11174247 DOI: 10.4103/jpbs.jpbs_506_23] [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: 08/06/2023] [Revised: 09/04/2023] [Accepted: 09/19/2023] [Indexed: 06/18/2024] Open
Abstract
Introduction The misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have emphasized the need to reduce and limit the precipitation. In this study we aimed to identify the prevalence, type, dose, and duration of antibiotics prescribed by general medical and dental practitioners in Saudi Arabia. Materials and Methods This cross-sectional study was performed from April 2020 to December 2020. A total of 45,100 antibiotic prescriptions were collected from different governmental and private pharmacies and screened to be included in this study. Data extraction from all prescriptions followed a standardized form that included the following information: Doctor specialty, type of antibiotic, duration, and dose of antibiotic. Results A total of 38,175 antibiotic prescriptions prescribed by licensed doctors practicing in governmental or private hospitals were included in this study. Thirty-five thousand one hundred and seventy-eight (92%) outpatient antibiotics were prescribed by medical practitioners, and 2997 (8%) antibiotics were prescribed by dentists. The most commonly prescribed antibiotic was Augmentin (60%), followed by metronidazole and amoxicillin (35%). The most common dose and duration prescribed by dentists for Augmentin was 625 mg, 3 times per day for 5 days, whereas that of metronidazole was 500 mg, 3 times per day for 7 days. Prescribed dose and duration of amoxicillin was 500 mg, 3 times per day for 7 days. Conclusions This study helps in understanding healthcare practitioners' patterns and adds to the knowledge on how to deal with odontogenic infections. Further national studies are recommended to include more regions in Saudi Arabia and to illustrate the misuse of outpatient antibiotics.
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Affiliation(s)
- Waleed Almutairi
- Department of Endodontics, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - Ali S Alrasheed
- Dental Intern, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - Yasir K Alaglan
- Dental Intern, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - Saleh Aleyeoni
- Dental Intern, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - Abdulmajeed Almogbel
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Qassim University, Qassim, Saudi Arabia
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Săndulescu O, Preoțescu LL, Streinu-Cercel A, Şahin GÖ, Săndulescu M. Antibiotic Prescribing in Dental Medicine-Best Practices for Successful Implementation. Trop Med Infect Dis 2024; 9:31. [PMID: 38393120 PMCID: PMC10892960 DOI: 10.3390/tropicalmed9020031] [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: 11/22/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/25/2024] Open
Abstract
With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial prescriptions. In this narrative review, we have analyzed the current state of the knowledge, attitudes, and practice regarding antimicrobial use among dental professionals, and we have identified a set of seven recurring themes that drive inappropriate antibiotic prescribing in dental medicine. These include: 1. Prescribing antibiotics to delay or avoid dental treatment. 2. Overlooking the 5Ds-dental treatment (source control), dental condition (indication), drug (antibiotic choice), dose, and duration. 3. Relying on education from the distant past and on previous experience. 4. The heterogeneity of (too many) guideline recommendations leads to confusion and over-prescribing. 5. Decreased access to guideline information in private practice. 6. Psychological factors such as pressure to prescribe, comfort prescribing and the weekend effect, and 7. Feeling removed from antimicrobial resistance and externalizing responsibility. Based on the existing knowledge, we propose a framework based on four key pillars for focused intervention: 1. Education. 2. Internalizing responsibility. 3. Recognizing recurring counter-productive practices, and 4. Addressing recurring counter-productive practices. This framework can be applied in different dental settings to ensure best practices for the successful implementation of rational antimicrobial prescribing.
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Affiliation(s)
- Oana Săndulescu
- Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Liliana Lucia Preoțescu
- Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Adrian Streinu-Cercel
- Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Gülşen Özkaya Şahin
- Department of Translational Medicine, Faculty of Medicine, Lund University, 223 62 Malmö, Sweden
- Department of Laboratory Medicine, Section of Clinical Microbiology, Region Skåne, 221 85 Lund, Sweden
| | - Mihai Săndulescu
- Department of Implant-Prosthetic Therapy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, 010221 Bucharest, Romania;
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Mubarak A, Alwafi MM, Alharbi RM, Alserhani SA, Khushaim RF, Almadani GZ, Nourwali IM, Alassaf MS. Knowledge and Attitude Toward Antibiotic Prescription Among Dental Students and Interns at Multiple Universities in Saudi Arabia. Cureus 2024; 16:e51777. [PMID: 38187030 PMCID: PMC10771713 DOI: 10.7759/cureus.51777] [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] [Accepted: 01/07/2024] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Dental students in Saudi Arabia are authorized to write prescriptions for antibiotics during practical training. Adverse side effects and resistance could result from inappropriate prescription. Accordingly, there is a need to evaluate the knowledge of dental students regarding guidelines and applications of antibiotic prescription. OBJECTIVES To assess the knowledge and attitude toward guidelines and applications of antibiotic prescription among dental students and interns at multiple universities in Saudi Arabia. METHODS A cross-sectional study was conducted among dental students in their final clinical years (4th to 6th year) and dental interns. The study data were collected using a valid and reliable structured questionnaire comprising three domains: 1) demographic characteristics, 2) knowledge, and 3) attitude toward antibiotic prescription for dental and systemic conditions. The data were analyzed and presented as frequency percentages, and the chi-square test was used to compare the knowledge and attitude items between the dental students and interns. The statistical significance level was set at p ≤ 0.05. RESULTS A total of 248 participants (women: 55.6%, men: 44.4%) were included in the study. Approximately 21.8% were 4th year students; 17.7%, 5th year students; 12.9%, 6th year students; and 47.6%, interns. For most items, the knowledge level was relatively high, and the attitude was generally positive among the participants. Approximately, 87.1% had good knowledge about current guidelines for antibiotic prophylaxis, 83.9% about antibiotic prescription, and 95.2% about antibiotic resistance. The interns showed significantly higher knowledge levels and favorable attitude, particularly for guidelines and applications of antibiotic prescription and correct use of antibiotics for oral cases, than did the students. Amoxicillin was the most frequently prescribed antibiotic among the participants. CONCLUSION The interns and 6th-year students demonstrated a relatively high knowledge level and positive attitude toward appropriate antibiotic prescriptions. However, deficiencies were observed among the students in their early clinical years, particularly for systemic conditions. These findings highlight the importance of implementing educational campaigns and providing guidelines to promote the appropriate use of antibiotics among dental students in their final clinical years.
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Affiliation(s)
| | - Malak M Alwafi
- Pediatric Dentistry and Orthodontics, Taibah University, Madinah, SAU
| | - Rahaf M Alharbi
- Department of Dental Education, Taibah University, Madinah, SAU
| | | | | | | | - Ibrahim M Nourwali
- Department of Oral and Maxillofacial Surgery, Taibah University, Madinah, SAU
| | - Muath S Alassaf
- Orthodontics and Dentofacial Orthopedics, Taibah University, Madinah, SAU
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Tousi F, Al Haroni M, Lie SA, Lund B. Antibiotic prescriptions among dentists across Norway and the impact of COVID-19 pandemic. BMC Oral Health 2023; 23:649. [PMID: 37684614 PMCID: PMC10492408 DOI: 10.1186/s12903-023-03380-6] [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: 05/01/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The prescription of antibiotics in dental practice contributes significantly to the total use of antibiotics in primary healthcare. This study aimed to evaluate antibiotic prescription in dental practice during the years 2016-2021 in Norway and their relative contribution to national outpatient consumption and to investigate the influence of age, gender, geographic region, and COVID-19. A further aim was to review differences in prescribing patterns to verify effect of governmental strategies to reduce over-prescribing of antibiotics. METHODS This register study investigated the national antibiotic prescription between 2016 and 2021. Data was obtained from the Norwegian prescription register, the Norwegian Institute of Public Health and Statistics Norway. The consumption of 12 common antibiotics was measured using WHO defined daily doses (DDDs), DDD per 1000 inhabitants per day (DIDs 1000). RESULTS A total of 6,049,445 antibiotic prescriptions of the 12 investigated compounds were issued in primary care during the study period. Dentists accounted for 942,350 prescriptions corresponding to 15.6% of the total. An overall decrease in the number of prescriptions by health professions other than dentists during the 5 years (IRR = 0.92, 95% CI:0.92-0.93, p < 0.001) was observed. For dentists a slight increase in the number of prescriptions (IRR = 1.01, 95% CI: 1.01-1.01, p < 0.001) was seen over the study period. The increase of antibiotic prescriptions in dentistry was more pronounced during the COVID-19 pandemic. The 4 most prescribed type of antibiotics based on average number of DDDs of the total period 2016-2021 were in descending order; phenoxymethylpenicillin (1,109,150) followed by amoxicillin (126,244), clindamycin (72,565), and metronidazole (64,599). An unexpected finding was that the prescription of the combination compound amoxicillin/clavulanic acid had significantly increased in dentistry during the last 5 years. Geographic, gender, and age differences in the rates of prescriptions were also seen. The data revealed that there are seasonal variations in dental prescriptions. CONCLUSIONS Noticeable differences exist in prescribing patterns of antibiotics in the last 5 years. Restricted access to dental care due to COVID-19 may have resulted in increased antibiotic prescribing in dentistry as opposed to an otherwise downward trend. Despite national guidelines there is still a need for improvement of antibiotic stewardship in dentistry and to define effective methods to disseminate information.
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Affiliation(s)
- Farnoush Tousi
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Mohammed Al Haroni
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.
- Centre for New Antimicrobial Strategies, UiT the Arctic University of Norway, Tromsø, Norway.
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Bodil Lund
- Department of Dental Medicine, Karolinska Institute, Stockholm, 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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Albalawi L, Alhawiti AS, Alnasser D, Alhumaidi J, Alrashidi T, Alnawmasi AM, Ali MAS, Alqifari S, Alshareef H. Knowledge, Attitudes, and Practices among Pharmacy and Non-Pharmacy Interns in Saudi Arabia Regarding Antibiotic Use and Antibiotic Resistance: A Cross-Sectional Descriptive Study. Healthcare (Basel) 2023; 11:healthcare11091283. [PMID: 37174825 PMCID: PMC10178345 DOI: 10.3390/healthcare11091283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/18/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
This cross-sectional descriptive study aims to explore the knowledge, attitudes, and practices among pharmacy, dentistry, medicine, and nursing interns in Saudi Arabia regarding antibiotic use and antibiotic resistance. Interns received a soft copy of a structured and validated self-administered questionnaire using an online survey platform. A total of 266 interns responded to the questionnaire. On average, the participants achieved good scores in the knowledge and practice domains, followed by the attitude domain. The average knowledge percentage was 76.1% (SD 17.1) compared to 84.6% (SD 20.5) for practices and 61.5% (SD 23.2) for attitudes. The results suggest that pharmacy interns had insignificantly better overall scores compared to non-pharmacy interns for knowledge, attitudes, and practices. This study shows that the scores for knowledge, attitudes, and practices of pharmacy, dentistry, medicine, and nursing interns regarding antibiotic use and resistance were high overall. However, interns' belief in their responsibility in preventing antibiotic resistance is lacking.
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Affiliation(s)
- Laila Albalawi
- Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Abeer S Alhawiti
- Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Dania Alnasser
- Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | | | - Tahani Alrashidi
- Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | | | - Mostafa A S Ali
- Pharmacy Practice Department, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
- Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt
| | - Saleh Alqifari
- Pharmacy Practice Department, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Hanan Alshareef
- Pharmacy Practice Department, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
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Rodríguez-Fernández A, Vázquez-Cancela O, Piñeiro-Lamas M, Herdeiro MT, Figueiras A, Zapata-Cachafeiro M. Magnitude and determinants of inappropriate prescribing of antibiotics in dentistry: a nation-wide study. Antimicrob Resist Infect Control 2023; 12:20. [PMID: 36941734 PMCID: PMC10026418 DOI: 10.1186/s13756-023-01225-z] [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: 10/22/2022] [Accepted: 02/26/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Dentist play an important role in misuse of antibiotics. Identification of the dental activities linked to the misuse of antibiotics is important for improving dentists' prescribing quality. The aim of the study was to quantify the magnitude of inappropriate antibiotic prescribing by dentists in Spain and identify the characteristics, knowledge and attitudes that influence prescribing quality. MATERIAL AND METHODS We conducted a cross-sectional, questionnaire-based study on dentists in Spain, assessing prescribing quality (dependent variable) on the basis of their responses about the prescription of antibiotics in 14 clinical situations. As the independent variables, we assessed professional characteristics and attitudes (lack of knowledge, fear, complacency, scheduling problems, and economic benefit) measured on a Likert scale. Odds Ratios (OR) (95%CI) were calculated using logistic regression. RESULTS A total of 878 participants were included in the analysis. Half of all dentists displayed inappropriate antibiotic prescribing habits in more than 28.6% (10/14) of the clinical situations posed (interquartile range 57-79%). Prescribing quality increased when resistance was perceived as a public health problem (OR 0.88, 95% CI: 0.79-0.97), and decreased in response to fear (OR 1.12, 95% CI:1.07-1.18) or the pursuit of economic benefit (OR 1.07, 95% CI 1.01-1.14). Having over 30 years' experience (OR 4.58, 95% CI:1.80-12.48) and/or practising in the field of prosthodontics as opposed to endodontics (OR 2.65, 95% CI:1.26-5.71) were associated with worse prescribing quality. CONCLUSIONS Antibiotics are the most commonly prescribed drugs in dentistry, and in many cases this prescription is inappropriate. Our findings shows that modifiable factors influence prescribing quality among dentists in Spain. These may be use for designing educational and training programmes for dentists.
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Affiliation(s)
- Almudena Rodríguez-Fernández
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain
| | - Olalla Vázquez-Cancela
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain.
- Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital, Santiago de Compostela, Spain.
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
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Chehabeddine N, Lahoud N, Noujeim ZEF, Zeidan RK, El Toum S, Maison P, Saleh N. An evaluation of prophylactic and therapeutic antibiotic prescribing in Lebanese dental practice. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 30:75-81. [PMID: 34718582 DOI: 10.1093/ijpp/riab042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/28/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To evaluate antibiotic prescribing patterns and correlates among Lebanese dentists. METHODS A descriptive observational study was conducted, from the first of April to the end of May 2017. Dentists who specialized in oral dental surgery or general dental practitioners were eligible to participate in this study. All patients who sought consultation with the selected dentists over a 1 month period were included. KEY FINDINGS A total of 2323 oral and dental procedures were performed by 60 dentists; 553 antibiotic prescriptions were prescribed, representing 23.8% (52.35% for prophylactic purposes and 47.65% for curative purposes). Prophylactic indications were mainly for implant surgery (36.3%) with only 1% appropriate. Curative use was mainly for periodontal abscesses/abscesses (indeterminate) (22.8%), followed by pulpal diseases and periradicular complications (20.5%); it was appropriate in only 1.7 and 1.9% of cases respectively. Amoxicillin-clavulanic acid was the antibiotic that was mostly prescribed for both curative and prophylactic uses (57.6 and 55.9%, respectively), followed by amoxicillin for prophylactic purposes and a combination of spiramycin plus metronidazole for curative purposes. Adherence to guidelines was low for both curative and prophylactic purposes (17.4 and 21.8%, respectively), but was better in patients who were younger [adjusted odds ratio (aOR) = 0.96], male (aOR = 0.40), or had cardiac disease with moderate or high infective endocarditis risk (aOR = 21.72), and when prescribed by oral surgeons (aOR = 0.15). CONCLUSIONS This study showed evidence of the overuse of antibiotics among Lebanese dentists. It can serve as a basis for future studies to optimize antibiotic use among dentists in Lebanon.
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Affiliation(s)
| | - Nathalie Lahoud
- Faculty of Public Health, Lebanese University, Fanar Lebanon.,CERIPH; Center for Research in Public Health - Pharmacoepidemiology Surveillance Unit - Faculty of Public Health, Lebanese University, Fanar Lebanon.,INSPECT-LB; Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Fanar Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut Lebanon
| | - Ziad E F Noujeim
- Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Lebanese University, Beirut Lebanon
| | - Rouba K Zeidan
- Faculty of Public Health, Lebanese University, Fanar Lebanon.,CERIPH; Center for Research in Public Health - Pharmacoepidemiology Surveillance Unit - Faculty of Public Health, Lebanese University, Fanar Lebanon.,INSPECT-LB; Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Fanar Lebanon
| | - Sami El Toum
- Faculty of Dental Medicine, Department of Oral and Maxillofacial Radiology, Lebanese University, Beirut Lebanon
| | - Patrick Maison
- CERIPH; Center for Research in Public Health - Pharmacoepidemiology Surveillance Unit - Faculty of Public Health, Lebanese University, Fanar Lebanon.,IST-PE, CHIC, F-94000 Créteil France.,EA 7379 EpidermE, Université Paris-Est Créteil, UPEC, Créteil, F-94010 France
| | - Nadine Saleh
- Faculty of Public Health, Lebanese University, Fanar Lebanon.,CERIPH; Center for Research in Public Health - Pharmacoepidemiology Surveillance Unit - Faculty of Public Health, Lebanese University, Fanar Lebanon.,INSPECT-LB; Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Fanar Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut Lebanon
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Alobaid MA, Alobaid S, Alshahrani M. Comparison of the Views of the General Dental Practitioners and Dental Interns in Asir, Saudi Arabia on Antibiotic Prescription for Endodontic Therapy: A Cross-Sectional Study. Infect Drug Resist 2021; 14:3001-3009. [PMID: 34393493 PMCID: PMC8360359 DOI: 10.2147/idr.s321938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022] Open
Abstract
AIM To assess the views of the dental interns (DIs) and general dental practitioners (GDPs) in the Asir region of Saudi Arabia on antibiotic prescription for endodontic therapy. METHODS The link to a cross-sectional online survey with 16 quantitative and qualitative questions was e-mailed to 60 DIs at the College of Dentistry of King Khalid University (group 1 [G1]) and 60 GDPs at the governmental primary healthcare centers in the Asir region of Saudi Arabia (group 2 [G2]). The data obtained from the survey were then subjected to a comparative statistical analysis. The inter-group statistical comparison of the distribution of categorical variables was tested using the chi square test or the Fisher's exact probability test if more than 20% of the cells had an expected frequency of less than 5. The p-values > 0.05 were considered statistically significant. The data were statistically analyzed using Statistical Package for Social Sciences (SPSS version 22.0, IBM Corporation, USA) for MS Windows. RESULTS The response rate was 83.3% for G1 and 63.33% for G2. Of the participants in G2, 39.5% had 1-5 years' clinical experience (the participants in G1 had no clinical experience). The number of endodontic emergency patients seen per day was significantly higher in G1 (88% and 63.2% of the participants in G1 and G2, respectively, were seeing 0-3 endodontic emergency patients per day). There was an insignificant difference between G1 and G2 in awareness of the existence of antibiotic prescription guidelines in endodontic therapy (57.9% and 56.0%, respectively; p > 0.05). There was also an insignificant difference between the groups in the rate of antibiotic prescription for endodontic problems, with 84% of the G1 participants and 86.8% of the G2 participants prescribing antibiotics only for limited patients. In the analysis of the clinical-vignette items (Q11-16), it was found that the rate of antibiotic prescription did not significantly differ between G1 and G2 (p > 0.05). No significant difference was found in the rate of antibiotic prescription for symptomatic reversible pulpitis, symptomatic irreversible pulpitis, and chronic apical periodontitis cases (p > 0.05). In contrast, the rate of antibiotic prescription for the symptomatic apical periodontitis, acute apical abscess, and systemic complications cases differed significantly (8% for G1 and 18.4% for G2, 54% for G1 and 76.3% for G2, and 98% for G1 and 73.7% for G2, respectively). CONCLUSION No significant difference in the rate of antibiotic prescription was found between the DIs and GDPs in this study. However, both groups showed an inappropriate rate of antibiotic prescription for some endodontic conditions. Further and more extensive studies involving a wider geographical region and different colleges of dentistry in Saudi Arabia are recommended.
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Affiliation(s)
- Mohammed A Alobaid
- Restorative Dental Science Department & Department of Dental Education, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Saad Alobaid
- Dental Department, Medical Services/King Khalid University Medical Hospital, Abha, Saudi Arabia
| | - Mohammed Alshahrani
- Dental Clinic in Primary Health Care Center, Ministry of Health, Abha, Saudi Arabia
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Karobari MI, Khijmatgar S, Bhandary R, Krishna Nayak US, Del Fabbro M, Horn R, Marya A. A Multicultural Demographic Study to Analyze Antibiotic Prescription Practices and the Need for Continuing Education in Dentistry. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5599724. [PMID: 34327231 PMCID: PMC8310454 DOI: 10.1155/2021/5599724] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/12/2021] [Accepted: 07/07/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The objective of the study was to understand and analyze the prescription patterns of dentists across various demographic locations for managing oral infections and pain with antibiotics and explore the evidence-based practices by clinicians as well as the need for further education. Materials and methods. This cross-sectional study was carried out using an online questionnaire framed to explore the knowledge, attitude, and practices among dentists with varying levels of experience and qualifications, regarding antimicrobial prescription. The questions were validated from previous published studies that explored the knowledge, attitude, and practice (KAP) with respect to antimicrobial prescription. In total, N = 300 of dentists from four different countries responded to the online questionnaire out of which 53% were specialists while 47% were general dentists. After data collection, descriptive analysis was carried out along with a one-sided hypothesis test to depict the power of the sample. RESULTS It was seen from the results of the study that the first-choice antibiotics for 67.8% of dentists were found to be the β-lactam group while sulfonamides and tetracyclines at 20% were the second most prescribed group. Another important finding was that 45.6% of dentists ignored hypersensitivity testing before prescription of antibiotics even though 83.3% of the total dentists interviewed were aware of the increase in antibiotic resistance. CONCLUSION In conclusion, the dentists are partially aware of the guidelines but need further training and education on antimicrobial prescription that enables evidence-based decision-making for better practices and outcomes.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
- Nitte (Deemed to Be University), AB Shetty Memorial Institute of Dental Sciences, Department of Oral Biology and Genomic Studies, Mangalore, India
| | - Rahul Bhandary
- Nitte (Deemed to Be University), AB Shetty Memorial Institute of Dental Sciences, Department of Periodontics, Mangalore, India
| | - U. S. Krishna Nayak
- Nitte (Deemed to Be University), AB Shetty Memorial Institute of Dental Sciences, Department of Orthodontics, Mangalore, India
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
- IRCCS Galeazzi Orthopedic Institute, Via Riccardo Galeazzi, 4, 20161 Milano, Italy
| | - Rithvitou Horn
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- Department of Orthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Smith A, Al-Mahdi R, Malcolm W, Palmer N, Dahlen G, Al-Haroni M. Comparison of antimicrobial prescribing for dental and oral infections in England and Scotland with Norway and Sweden and their relative contribution to national consumption 2010-2016. BMC Oral Health 2020; 20:172. [PMID: 32546149 PMCID: PMC7298788 DOI: 10.1186/s12903-020-01163-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 06/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Prescribing in dental practice has a relatively small but important contribution to the quantity of antibiotics prescribed in primary care. This study aimed to analyse antibiotic prescribing in dentistry over time (2010-2016) in 4 different Northern European countries and their relative contribution to national outpatients consumption. METHODS This retrospective study evaluated the frequency and number of national antibiotic prescriptions written by dentists in England, Scotland, Norway and Sweden. The consumption of such antibiotics was measured using WHO defined daily doses (DDDs), DDDs per 100,000 inhabitants per day (DIDs100,000). RESULTS A total of more than 27 million prescriptions (27,026,599) archived between 2010 and 2016 from the four countries were analysed. The national contribution of Norwegian dentists to the total primary care prescription during this period was 8%. The corresponding figures for Sweden, Scotland and England were 7, 6, and 8%. Dental contribution to National antibiotic use in all four countries has decreased over the study time period for commonly prescribed antibiotics in dentistry, i.e., the beta-lactams (Phenoxymethyl penicillin/Amoxicillin) and metronidazole. There were less numbers of prescriptions by dentists in Norway and Sweden compared to England and Scotland. Marked differences in some classes of antibiotics were noted with Phenoxymethyl penicillin dominating in Sweden/Norway compared to Amoxicillin and Metronidazole in England/Scotland. In England and Scotland, dentists were the largest prescribers of metronidazole in primary care. Clindamycin prescriptions was higher in Norway and Sweden. CONCLUSION Noticeable differences exist in prescribing patterns for the management of oral infections. High levels of metronidazole use in England and Scotland also require further analysis. All countries over the study period showed a decrease in total numbers of antibiotics prescribed.
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Affiliation(s)
| | - Rania Al-Mahdi
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromso, Norway
| | - William Malcolm
- Health Protection Scotland, NHS National Services Scotland, Glasgow, Scotland, UK
| | | | - Gunnar Dahlen
- Institute of odontology, University of Gothenburg, Gothenburg, Sweden
| | - Mohammed Al-Haroni
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromso, Norway.
- Centre for New Antimicrobial Strategies, UiT the Arctic University of Norway, Tromso, Norway.
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12
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Cummins J, McCarthy M, Esterman A, Karve A, Lee A. Knowledge and Compliance of Dentists' and Dental Students' With Respect to Relevant Guidelines for Prescribing Antibiotic Prophylaxis for the Prevention of Infective Endocarditis: A Systematic Review. J Evid Based Dent Pract 2020; 20:101311. [DOI: 10.1016/j.jebdp.2019.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 01/17/2019] [Accepted: 01/23/2019] [Indexed: 12/26/2022]
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13
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Brinkman DJ, Nijland N, van Diermen DE, Bruers JJM, Ligthart WSM, Rietveld PJ, Tams J, Vissink A, Wilhelm AJ, Rozema FR, Tichelaar J, van Agtmael MA. Are Dutch dental students and dental-care providers competent prescribers of drugs? Eur J Oral Sci 2019; 127:531-538. [PMID: 31821657 PMCID: PMC6973271 DOI: 10.1111/eos.12658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2019] [Indexed: 11/26/2022]
Abstract
Dental students and dental‐care providers should be able to prescribe drugs safely and effectively. As it is unknown whether this is the case, we assessed and compared the prescribing competence of dental students and dental‐care providers in the Netherlands. In 2017, all Dutch final‐year dental students and a random sample of all qualified general dental practitioners and dental specialists (oral and maxillofacial surgeons and orthodontists) were invited to complete validated prescribing knowledge‐assessment and skills‐assessment instruments. The knowledge assessment comprised 40 multiple‐choice questions covering important drug topics. The skills assessment comprised three common clinical case scenarios. For the knowledge assessment, the response rates were 26 (20%) dental students, 28 (8%) general dental practitioners, and 19 (19%) dental specialists, and for the skills assessment the response rates were 14 (11%) dental students, eight (2%) general dental practitioners, and eight (8%) dental specialists. Dental specialists had higher knowledge scores (78% correct answers) than either dental practitioners (69% correct answers) or dental students (69% correct answers). A substantial proportion of all three groups made inappropriate treatment choices (35%–49%) and prescribing errors (47%–70%). Although there were some differences, dental students and dental‐care providers in the Netherlands lack prescribing competence, which is probably because of poor prescribing education during under‐ and postgraduate dental training. Educational interventions are urgently needed.
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Affiliation(s)
- David J Brinkman
- Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Nina Nijland
- Faculty of Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Denise E van Diermen
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Josef J M Bruers
- Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.,Department of Research and Information, Royal Dutch Dental Association (KNMT), Nieuwegein, The Netherlands
| | | | - Patrick J Rietveld
- Faculty of Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jan Tams
- Faculty of Dentistry, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Abraham J Wilhelm
- Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Frederik R Rozema
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jelle Tichelaar
- Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Michiel A van Agtmael
- Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
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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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15
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Aboalshamat KT, Banjar AM, Al-Jaber MI, Turkistani NM, Al-Amoudi MT. The Effectiveness of Online Course Intervention to Improve Knowledge of Antimicrobial Resistance among Dental Students, in Comparison to Reference Group Using a Randomized Controlled Trial. Open Access Maced J Med Sci 2019; 7:2917-2923. [PMID: 31844458 PMCID: PMC6901864 DOI: 10.3889/oamjms.2019.723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 11/05/2022] Open
Abstract
AIM This study aimed to assess the effectiveness of a recognised antimicrobial resistance (AMR) online module on knowledge and perception among dental students, using a randomised controlled trial study design. METHODS Dental students (n = 64, aged 21-25 years) in clinical years agreed to participate in this triple-blinded, parallel, randomised controlled trial. There were 34 students in the study group and 30 students in the control group. The study group participated in an online course covering information about AMR, while students in the control group received another online course about microorganisms in dentistry. Both groups were assessed three times using online questionnaires: before the intervention (T1), after the intervention (T2), and two months later (T3). Each one of T1, T2 and T3 had 22 questions. The questions were repeated each time in T1, T2, and T3 asking about AMR but with different question format, to avoid the possibility of students to memorise the answers. RESULTS The mean (m) of correct answers for all students on T1 was 12.56, with standard deviation (SD) of 3.2. On T2, m = 14.03 and SD = 3.85, and on T3, m = 14.36 and SD = 3.71. Scores ranged from 0 to 22. The participants in the study and control groups showed significant score improvements from T1 to T2, immediately after the intervention, but there was no significant difference between T2 and T3. The study group students' scores did not improve significantly from T1 to T3, in contrast to the control group students' scores. More importantly, there was no significant difference in improvement from T1 to T2 when comparing the study and control groups. CONCLUSION Online courses might not be reliable learning methods for ensuring the optimal levels of AMR knowledge that are needed by dental practitioners.
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Affiliation(s)
- Khalid T. Aboalshamat
- Dental Public Health Division, Preventative Dentistry Department, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Assim M. Banjar
- College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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16
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Ong A, Kim J, Loo S, Quaranta A, Rincon A JC. Prescribing trends of systemic antibiotics by periodontists in Australia. J Periodontol 2019; 90:982-992. [PMID: 30825215 DOI: 10.1002/jper.18-0586] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/12/2018] [Accepted: 02/22/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Antibiotics are a common systemic pharmaceutical therapy in periodontal conditions for dental practitioners as well as specialists. However, there is limited information about prescribing patterns amongst the periodontists within Australia. The objective of this study is to examine current patterns and perceptions in prescribing systemic antibiotics for the treatment of periodontal and peri-implant diseases. METHODS An online questionnaire was disseminated to Australian practicing members of the Australia and New Zealand Academy of Periodontists (ANZAP) to determine their antibiotic prescribing patterns for different periodontal conditions. Indications that were analyzed included: chronic periodontitis, plaque-induced gingivitis, aggressive periodontitis, acute gingival and periodontal conditions, conditions associated with implants and implant placement, periodontal regeneration, and mucogingival surgery. RESULTS Out of the 50 members that participated in the study, 38 completed the questionnaire. Systemic antibiotics prescription patterns varied markedly for different periodontal or peri-implant diseases among respondents. 79% reported prescription of systemic antibiotics in the treatment of chronic periodontitis whereas 52.6%, 55.3%, 18.4% of the respondents did so for periodontal regeneration procedures, implant placement surgery, and mucogingival surgery, respectively. Azithromycin, the combination of Amoxicillin and Metronidazole, and Amoxicillin were the three most commonly prescribed systemic antibiotics. CONCLUSION Based on the results of this survey, systemic antibiotics are widely used by the group of periodontists surveyed in this study in Australia with varying rates and patterns for different periodontal and peri-implant conditions. The current study highlights the need for recommendations and guidelines in the prescription of antibiotics for periodontal and peri-implant conditions.
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Affiliation(s)
- Alex Ong
- University of Western Australia Dental School, The University of Western Australia, Perth, Australia
| | - Junghyun Kim
- University of Western Australia Dental School, The University of Western Australia, Perth, Australia
| | - Samuel Loo
- University of Western Australia Dental School, The University of Western Australia, Perth, Australia
| | - Alessandro Quaranta
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Julio C Rincon A
- University of Western Australia Dental School, The University of Western Australia, Perth, Australia
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17
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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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18
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Mansour H, Feghali M, Saleh N, Zeitouny M. Knowledge, practice and attitudes regarding antibiotics use among Lebanese dentists. Pharm Pract (Granada) 2018; 16:1272. [PMID: 30416630 PMCID: PMC6207361 DOI: 10.18549/pharmpract.2018.03.1272] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/20/2018] [Indexed: 01/15/2023] Open
Abstract
Objectives: Explore antibiotic use, assess conformity with evidence-practice guidelines, and describe knowledge and attitudinal factors among Lebanese dentists. Methods: National cross-sectional telephonic survey, using a standardized questionnaire addressing demographic, educational and professional data, usual antibiotics prophylactic and curative prescription pattern and influential factors, knowledge concerning antibiotics use in selected patient-populations, and attitude regarding antimicrobial resistance. Analyses used descriptive statistics, and bivariate analysis to observe predictors of higher knowledge. Results: the overall response rate for the study was around 21%. 322 dentists participated. On average, 17.51% of consultations resulted in antibiotic use; previous antibiotic experience mostly influenced prescriptions (81.3%). Referral of pregnant and lactating women and cardiac patients, when antibiotics are needed, was high (26.9%, 28.5% and 79.4%, respectively). Macrolides were the dominant first-line antibiotics in penicillin allergy (47.4%). Penicillins were most common for pregnant and lactating women. Penicillins (95.0%), 2g (63.9%), and 1 hour pre-procedure (34%) were the main components of prophylaxis for cardiac patients. Prophylactic and curative use varied widely; few dentists exhibited guideline-conform prescriptions. Mean knowledge scores of prophylaxis for cardiac and non-cardiac patients, and antibiotics’ side effects were predominantly poor (46.75±14.82, 39.21±33.09 and 20.27±18.77, respectively over 100). Practicing outside Beirut, undergraduate qualification in Lebanon, and post-graduate qualification predicted higher knowledge. 75.9% acknowledged the contribution of dentistry-based prescribing to antibiotic resistance and 94.7% knew at least one cause of resistance. Conclusions: Dentists show positive attitude towards antimicrobial resistance. Yet, they lack uniformity in antibiotic stewardship. Poor knowledge and guideline-incongruent prophylactic and therapeutic prescribing are observed. Development of targeted interventions is needed to promote judicious antibiotic use within Lebanese dentistry.
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Affiliation(s)
- Hicham Mansour
- Department of Restorative and Esthetic, Faculty of Dentistry, Lebanese University. Beirut (Lebanon).
| | - Mireille Feghali
- Department of Restorative and Esthetic, Faculty of Dentistry, Lebanese University. Beirut (Lebanon).
| | - Nadine Saleh
- Division of epidemiology and biostatistics - Faculty of Public Health - Lebanese University, Beirut (Lebanon).
| | - Mona Zeitouny
- Department of Restorative and Esthetic, Faculty of Dentistry, Lebanese University. Beirut (Lebanon).
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Menon RK, Gopinath D, Li KY, Leung YY, Botelho MG. Does the use of amoxicillin/amoxicillin-clavulanic acid in third molar surgery reduce the risk of postoperative infection? A systematic review with meta-analysis. Int J Oral Maxillofac Surg 2018; 48:263-273. [PMID: 30145064 DOI: 10.1016/j.ijom.2018.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/23/2018] [Accepted: 08/02/2018] [Indexed: 10/28/2022]
Abstract
The objectives of this systematic review were to investigate the efficacy of amoxicillin/amoxicillin-clavulanic acid for reducing the risk of postoperative infection after third molar surgery and to evaluate the adverse outcomes in these patients, as well as in healthy volunteers. A systematic search of four databases was performed on May 26, 2017. Eleven studies qualified for the qualitative analysis and eight were found suitable for meta-analysis. The results suggest that both amoxicillin-clavulanic acid and amoxicillin significantly reduce the risk of infection after third molar extraction (overall relative risk (RR) 0.25, P<0.001). However, with the exclusion of randomized controlled trials with a split-mouth design (due to an inadequate crossover period after antibiotic treatment), only amoxicillin-clavulanic acid was found to be effective (RR 0.21, P<0.001). The risk of adverse effects was significantly higher in the amoxicillin-clavulanic acid group (RR=4.12, P=0.023) than in the amoxicillin group (RR 1.57, P=0.405). In conclusion, amoxicillin-clavulanic acid and amoxicillin may significantly reduce the risk of infection after third molar extraction. However, their use in third molar surgery should be viewed with caution, as recent clinical trials on healthy volunteers have shown evidence of the negative impact of amoxicillin use on bacterial diversity and antibiotic resistance.
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Affiliation(s)
- R K Menon
- International Medical University, Kuala Lumpur, Malaysia; Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - D Gopinath
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - K Y Li
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Y Y Leung
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - M G Botelho
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.
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20
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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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21
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AboAlSamh A, Alhussain A, Alanazi N, Alahmari R, Shaheen N, Adlan A. Dental Students' Knowledge and Attitudes towards Antibiotic Prescribing Guidelines in Riyadh, Saudi Arabia. PHARMACY 2018; 6:pharmacy6020042. [PMID: 29735914 PMCID: PMC6025366 DOI: 10.3390/pharmacy6020042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 04/28/2018] [Accepted: 05/04/2018] [Indexed: 01/21/2023] Open
Abstract
Background: The use of antibiotics prophylactically and therapeutically in dentistry has become common practice. Inappropriate prescription may lead to adverse side effects and bacterial resistance. During clinical training, dental students in Saudi Arabia are authorized to prescribe antibiotics. Aim: To evaluate dental students’ knowledge and attitudes regarding antibiotic prescription in Riyadh, Saudi Arabia. Methods: A cross-sectional study based on a validated questionnaire consisting of 34 questions focusing on antibiotic indications in dentistry, antibiotic regimens, and knowledge regarding resistance was distributed amongst dental students in five leading dental colleges in Riyadh. Results: A large proportion of students (71.7%) were familiar with the concept of antibiotic resistance. When comparing junior and senior dental students’ knowledge with regards to indications of antibiotic use in commonly encountered conditions, it was found that there was no significant difference in antibiotic prescription frequency between these groups. Most dental students choose to prescribe amoxicillin as their first-choice of antibiotic (88.4%), and most also chose to use it for a duration of 3–5 days (69.2%). Conclusions: This study concludes that dental students may prescribe antibiotics inappropriately to manage various conditions when not indicated. This may indicate a defect in education of students with regards to current antibiotic guidelines.
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Affiliation(s)
| | | | - Nawaf Alanazi
- College of Dentistry, Al Jouf University (JU), Sakakah 72388, Saudi Arabia.
| | - Rakan Alahmari
- College of Dentistry, King Khalid University (KKU), Abha 62529, Saudi Arabia.
| | - Naila Shaheen
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 14611, Saudi Arabia.
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 14811, Saudi Arabia.
| | - Abdallah Adlan
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 14611, Saudi Arabia.
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 14811, Saudi Arabia.
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