Antibiotics prescription habits of Spanish endodontists: Impact of the ESE awareness campaign and position statement

Marrufo-Medina, A. López; Domínguez-Domínguez, Laura; Cabanillas-Balsera, Daniel; Areal-Quecuty, Victoria; Crespo-Gallardo, Isabel; Jiménez-Sánchez, MC.; López‐López, José; Segura-Egea, JJ; Martín-González, Jénifer

doi:10.4317/jced.59053

Cited by 6 publications

(11 citation statements)

References 22 publications

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“…This study reflects the current state of knowledge and patient perception of antibiotic resistance and the use and need for systemic antibiotics in the treatment of pulpo-periapical infections. Previous studies [2,10,[14][15][16][17] have evaluated dentists' knowledge of antibioticprescribing habits. However, although it is known that dentists' prescribing habits are sometimes influenced by patient pressure, until now, no study had analyzed patients' knowledge and beliefs about antibiotic treatment in endodontics.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, the European Commission undertook a series of surveys among the general population to monitor their awareness and levels of use [8,9]. There is evidence that antibiotic prescription in endodontics is inadequate [10]; however, there is no evidence of the population's knowledge in this area. Some studies point to educational level as a variable to be taken into account in the fight against antibiotic resistance [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Patients’ Opinions on Antibiotics in the Treatment of Dental Infections: A Cross-Sectional Survey

Domínguez-Domínguez,

Castelo Baz,

Cabrera-Fernandez

et al. 2024

JCM

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Background: The aim of this study was to evaluate patients’ knowledge and perceptions of the use of systemic antibiotics in the treatment of endodontic infections and to determine the possible contribution of patients to the development of bacterial resistance. Methods: A total of 550 patients were asked to respond to a survey on the perception of systemic antibiotic use in the treatment of endodontic infections and antibiotic resistance during January 2022 and March 2023. A bivariate and multivariate analysis was performed to determine possible correlates in the population regarding antibiotic use in the endodontic world. Results: A total of 514 patients were included in the study, 65.9% of whom were women. While 34.6% of the population studied thought that it was always necessary to take antibiotics prior to endodontics, 49.4% considered that they were necessary after endodontics, regardless of the clinical symptoms. The prevalence of self-medication was 17.3%, and women self-medicate more than men, with significant differences (p < 0.05), although they have a greater knowledge of antibiotic resistance than men (p < 0.05). Forty-four percent of the population expected to take antibiotics when faced with dental pain, mainly women (p < 0.05). Conclusion: The general population is contributing to the serious problem of bacterial resistance. It is necessary to promote educational strategies focused on the correct use of antibiotics in the community. The worst results were found mainly in the population with a low level of education. The level of education was the variable that most influenced the knowledge and attitudes of the population, followed by the sex of the participants.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients’ Opinions on Antibiotics in the Treatment of Dental Infections: A Cross-Sectional Survey

Domínguez-Domínguez,

Castelo Baz,

Cabrera-Fernandez

et al. 2024

JCM

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“…All studies were cross-sectional surveys and level 4 evidence, according to the Center for Evidence-Based Medicine at Oxford [78]. Regarding the prescribers, seven studies included in the sample only endodontists [18,50,52,55,59,73,74], two studies [20,76] included two separated samples, endodontists and general practitioners, considered as two different studies in the meta-analysis, one study included only dental surgeons [75], and the rest included general practitioners.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Antibiotic Over-Prescription by Dentists in the Treatment of Apical Periodontitis: A Systematic Review and Meta-Analysis

Méndez-Millán,

León-López,

Martín-González

et al. 2024

Antibiotics

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After pulp infection and necrosis, the passage of microbial antigens into the periapical space causes apical periodontitis (AP). Most of the clinical forms of AP can be managed without prescribing antibiotics, only with root canal treatment and abscess drainage or, where appropriate, tooth extraction. However, the scientific literature provides evidence of inappropriate antibiotic prescriptions by dentists in the management of apical disease. Objectives: The aim of this systematic review and meta-analysis was to analyze the global pattern of antibiotic prescription in the treatment of apical disease. Methods: PRISMA Guidelines were followed to carry out this systematic review. The research question was as follows: What is the pattern of antibiotic prescription by dentists in the treatment of the different clinical forms of apical periodontitis? A systematic search was conducted on MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. All studies reporting data about the pattern of antibiotic prescription by dentists in the treatment of apical disease were included. The meta-analyses were calculated using the Open Meta Analyst version 10.10 software. Random-effects meta-analyses were performed. The risk of bias was assessed using the Newcastle–Ottawa Scale. The certainty of evidence was assessed using GRADE. Results: The search strategy identified 96 articles and thirty-nine cross-sectional studies fulfilled the inclusion criteria. The overall percentage of antibiotic prescriptions by dentists in cases of symptomatic AP was 25.8%, and 31.5% in cases of asymptomatic AP with sinus tract present. The percentage of dentists prescribing antibiotics in cases of acute apical abscess with no/mild symptoms was 47.7%, whereas, in cases of acute apical abscess with moderate/severe symptoms, 88.8% of dentists would prescribe antibiotics. Endodontists prescribe antibiotics at a lower rate than general practitioners. The total risk of bias was considered moderate, and the final rating for the certainty of the evidence was low. Conclusions: Dentists worldwide are over-prescribing antibiotics in the management of apical disease. It is necessary to improve antibiotic prescribing habits in the treatment of endodontic infections, as well as educational initiatives to encourage the rational and appropriate prescription of antibiotics in periapical diseases.

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“…commonly recommended antibiotics when they were not warranted, and dental faculty had a similar correct response rate to preclinical dental students. Other surveys have demonstrated opportunities for improvement in antibiotic prescribing decisions for endodontic patients, [11][12][13][14][15][16] patients undergoing dental implant placement, 17,18 emergency dental care, [19][20][21] and general dentistry. [22][23][24][25][26] Other conditions, such as use of systemic antibiotics prior to periodontic treatments, have shown considerable variability.…”

Section: <001mentioning

confidence: 99%

How decisions are made: Antibiotic stewardship in dentistry

Schneider-Smith

Suda

Lew

et al. 2023

Infect. Control Hosp. Epidemiol.

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Background: We performed a preimplementation assessment of workflows, resources, needs, and antibiotic prescribing practices of trainees and practicing dentists to inform the development of an antibiotic-stewardship clinical decision-support tool (CDST) for dentists. Methods: We used a technology implementation framework to conduct the preimplementation assessment via surveys and focus groups of students, residents, and faculty members. Using Likert scales, the survey assessed baseline knowledge and confidence in dental providers’ antibiotic prescribing. The focus groups gathered information on existing workflows, resources, and needs for end users for our CDST. Results: Of 355 dental providers recruited to take the survey, 213 (60%) responded: 151 students, 27 residents, and 35 faculty. The average confidence in antibiotic prescribing decisions was 3.2 ± 1.0 on a scale of 1 to 5 (ie, moderate). Dental students were less confident about prescribing antibiotics than residents and faculty (P < .01). However, antibiotic prescribing knowledge was no different between dental students, residents, and faculty. The mean likelihood of prescribing an antibiotic when it was not needed was 2.7 ± 0.6 on a scale of 1 to 5 (unlikely to maybe) and was not meaningfully different across subgroups (P = .10). We had 10 participants across 3 focus groups: 7 students, 2 residents, and 1 faculty member. Four major themes emerged, which indicated that dentists: (1) make antibiotic prescribing decisions based on anecdotal experiences; (2) defer to physicians’ recommendations; (3) have limited access to evidence-based resources; and (4) want CDST for antibiotic prescribing. Conclusions: Dentists’ confidence in antibiotic prescribing increased by training level, but knowledge did not. Trainees and practicing dentists would benefit from a CDST to improve appropriateness of antibiotic prescribing.

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Antibiotics prescription habits of Spanish endodontists: Impact of the ESE awareness campaign and position statement

Cited by 6 publications

References 22 publications

Patients’ Opinions on Antibiotics in the Treatment of Dental Infections: A Cross-Sectional Survey

Patients’ Opinions on Antibiotics in the Treatment of Dental Infections: A Cross-Sectional Survey

Antibiotic Over-Prescription by Dentists in the Treatment of Apical Periodontitis: A Systematic Review and Meta-Analysis

How decisions are made: Antibiotic stewardship in dentistry

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