Antibiotic prescribing practices of dentists for endodontic infections; a cross-sectional study

Abstract

Objective The indiscriminate prescription of antibiotics has led to the emergence of resistance microbes worldwide. This study aimed to investigate the antibiotic prescribing practices amongst general dental practitioners and specialists in managing endodontic infections in the United Arab Emirates (UAE). Design General dental practitioners and specialists in the UAE were invited to participate in an online questionnaire survey which included questions on socio-demographics, practitioner’s antibiotic prescribing preferences for various pulpal and periapical diseases, and their choice, in terms of the type, dose and duration of the antibiotic. The link to the survey questionnaire was sent to 250 invited dentists. Data were analyzed by descriptive statistics and chi-square tests for independence and level of significance was set at 0.05. Results A total of 174 respondents participated in the survey (response rate = 70%). The respondents who prescribed antibiotics at least once a month were 38.5% while 17.2% did so, more than three times a week; amoxicillin 500 mg was the antibiotic of choice for patients not allergic to penicillin (43.7%), and in cases of penicillin allergies, erythromycin 500 mg (21.3%). There was a significant difference in the antibiotic prescribing practices of GDPs compared to endodontists and other specialties especially in clinical cases such as acute apical abscesses with swelling and moderate to severe pre-operative symptoms and retreatment of endodontic cases (p<0.05). Approximately, three quarters of the respondents (78.7%) did not prescribe a loading dose when prescribing antibiotics. About 15% respondents prescribed antibiotics to their patients if they were not accessible to patients due to a holiday/weekend. Conclusions In general, the antibiotic prescribing practices of UAE dentists are congruent with the international norms. However, there were occasions of inappropriate prescriptions such as in patients with irreversible pulpitis, necrotic pulps with no systemic involvement and/or with sinus tracts.

A Multicultural Demographic Study to Analyze Antibiotic Prescription Practices and the Need for Continuing Education in Dentistry

“…Many of the findings of the study confirm findings from previous studies conducted across India, Malaysia, and Saudi Arabia that reported an excess use of antibiotics in situations where they may not be required [17,18]. Our study found that broad-spectrum antibiotics especially were being overprescribed in situations where they were not required such as irreversible pulpitis.…”

“…In recent years, there have been studies conducted in developing countries such as India, Saudi Arabia, and Malaysia where it has been shown that the antibiotic prescribing practices were exceedingly flawed [17][18][19][20]. These studies also concluded with the obvious need for educational programs and initiatives that could help rationalize the use of antibiotics by dental practitioners.…”

Impact of the COVID-19 pandemic on dental and medical education in Bangladesh: a pilot study and the implications

“…There has also been an increase in the prescribing of antibiotics for patients with suspected or confirmed COVID-19 in Bangladesh, similar to other countries, despite only a limited number of patients with COVID-19 having confirmed bacterial or fungal infections [12][13][14][15] . This builds on existing high and inappropriate rates of prescribing and dispensing of antibiotics generally in Bangladesh and wider among low-and middle-income countries (LMICs) including among dentists [16][17][18][19][20] . This is a concern as the over-use of antimicrobials increases antimicrobial resistance (AMR) with subsequent implications on morbidity, mortality and costs [20][21][22][23] .…”

Antibiotic indication in endodontics by Colombian dentists with different levels of training: a survey

“…The American Association of Endodontics (AAE) and the European Society of Endodontology (ESE) frequently revise the guidelines for endodontists regarding proper antibiotic prescription. There is general consensus that in most clinical endodontic situations, it suffices to provide local treatment with removal or reduction of the infection source, without using systemic antibiotics [8][9][10] . Different studies around the world have shown that dentists still prescribe antibiotics unnecessarily in endodontics [11][12][13][14] .…”