Appropriateness of Antibiotic Prescription for Prophylactic Purposes among Italian Dental Practitioners: Results from a Cross-Sectional Study

Abstract

The primary objective of this study was to investigate the pattern of antibiotic prescription for prophylaxis purposes among Italian DPs (dental practitioners). A nationwide cross-sectional study was conducted using a multi-stage sampling design. A structured questionnaire was used to collect socio-demographic data and information about antibiotic prophylaxis (AP) prescriptions for selected dental diagnoses and surgical procedures. The presence of an indication and appropriateness of AP were defined according to international guidelines. In total, 563 DPs answered the questionnaire (response rate 52.6%). The proportions of DPs who prescribed AP in the presence of an indication ranged from 39.1% for luxation injury with soft tissue trauma to 73.1% for dental implants, whilst DPs who prescribed AP in healthy patients ranged from 41.9% in luxation injury with soft tissue trauma to 70.3% for bone grafting. The course of AP reported by DPs was not consistent with the guidelines in 70.9% of explored procedures. A high proportion of AP prescriptions before dental procedures were unnecessary. This highlights the urgent need to incorporate recommendations for best practices into national and local protocols as soon as they are established. Specific antibiotic stewardship strategies targeted to DPs should be implemented and assessed for effectiveness in improving prescribing of antibiotics.

Attitudes towards Antibiotic Prescription and Antimicrobial Resistance Awareness among Italian Dentists: What Are the Milestones?

“…In addition, an exact response rate could not be computed. However, this study assessed antibiotic administration among Italian dentists not only for prophylactic purposes [ 8 ], but also therapeutic use, evaluating it in relation to dentists’ working experience, usual setting, and main practice. Moreover, different from other studies, the present survey specifically focused on dentists who voluntarily participated [ 45 ].…”

“…The participants were approached via Facebook, WhatsApp, and mailing lists, and the sample size was estimated from similar studies [ 8 ].…”

“…An alarming increase in antibiotic administration has been recorded globally as well as across Europe, resulting from excessive prescription rates not complying with antibiotic prescribing guidelines [ 6 , 7 ]. Between 30% and 66.5% of antibiotics prescriptions in medical settings are estimated to be unnecessary, and antibiotics are considered to be among the drugs most commonly prescribed in both dental outpatients and hospital inpatients [ 8 , 9 ]. Moreover, antibiotic overuse may also be ascribable to patients’ poor adherence to prescribed treatments, leading, in turn, to further antibiotic use.…”

Adjunctive Effect of Systemic Antibiotics in Regenerative/Reconstructive Periodontal Surgery—A Systematic Review with Meta-Analysis

“…In the era of increasing antimicrobial resistance, public health needs demand a reduction in the use of unnecessary antibiotic usage through antibiotic stewardship [ 45 ]. Although adjunctive systemic antibiotics have been shown to lead to enhanced clinical and radiographic outcomes following non-surgical periodontal therapy [ 3 ], a recent S3-level clinical guideline calls for a rather restrictive use in the non-surgical phase [ 6 ]; however, no evidence-based guidelines deal with the adjunctive prophylactic use of antibiotics in conjunction with periodontal surgery [ 12 , 13 , 46 , 47 ]. Despite their common use in practice, it has been unclear if their use in this scenario is justifiable.…”

Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy

“…As is known, vaccine hesitancy played an important role in COVID, even more than what is expected for other type of pathogens; such behavior impacts on disease spread and consequent drug prescription attitudes on the territory, and this all has a foreseeable impact on hospital demand [66][67][68]. In particular, antibiotic over prescription (by all types of health personnel) is constantly been linked with the occurrence of antimicrobial resistance, and thus with more difficulties in patient care management and further hospitalization increase [69][70][71][72].…”