The prescribing of antibiotics for endodontic infections by dentists in Turkey: a comprehensive survey
International Endodontic Journal, cilt.53, sa.12, ss.1715-1727, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 53 Sayı: 12
- Basım Tarihi: 2020
- Doi Numarası: 10.1111/iej.13390
- Dergi Adı: International Endodontic Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1715-1727
- Anahtar Kelimeler: antibiotic, antibiotic resistance, endodontic disease
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: To investigate the antibiotic prescribing patterns for endodontic infections based on the reports of Turkish dentists. Methodology: A survey consisting of 20 questions on general information and 13 questions on antibiotic prescribing patterns for endodontic cases was delivered to the e-mail addresses of general dentists and specialists via the database of the Turkish Dental Association. Collected data were analysed using Mc-Nemar-Bowker Test and multivariate ordinal logistic regression tests at the significance level of 0.05. Results: A total of 1007 responses were obtained from 17 827 dentists. The majority of the participants were general dental practitioners (GDP, 80%) whilst 8% were Endodontists. Gender, clinical experience, affiliations and speciality were significant risk factors for antibiotic prescription (P < 0.05). GDPs prescribed antibiotics twice as much as all specialists and members of public hospitals prescribed antibiotics three times more than specialists and clinical academics (P < 0.05). Amoxicillin with clavulanic acid was the most prescribed antibiotic (90%), followed by Ornidazole (25%). Clindamycin was the drug of choice for the patients with penicillin allergy (59%). Infection and fever control (76%), prophylaxis (44%) and avoiding swelling and trismus during endodontic treatment (26%) were the most common reasons for antibiotic prescriptions. Completing a course of prescribed antibiotics was recommended by most (75%). Infective endocarditis, immunosuppression, artificial heart valve and mitral valve prolapse were the main causes of prophylaxis in descending order. Uncontrolled and extensive use of antibiotics by patients (62%) was mentioned as the most effective reason for antibiotic resistance. Up to 10% of participants prescribed antibiotics for symptomatic irreversible pulpitis, asymptomatic apical periodontitis with or without endodontic treatment (8, 12 and 11%, respectively). Up to 20% of dentists prescribed antibiotics for symptomatic apical periodontitis when the pulp was vital or necrotic (13 and 23%, respectively). Almost one third of the participants prescribed antibiotics for symptomatic apical periodontitis of previously treated teeth with or without radiographic lesions whilst 34% prescribed antibiotics for acute apical abscess with localized swelling without systemic involvement. Conclusions: The majority of dentists reported they prescribed antibiotics inappropriately. It is necessary to improve the knowledge of dentists about antibiotics and their indications in endodontics.