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

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.

Systemic Antibiotic Use in Acute Irreversible Pulpitis: Evaluating Clinical Practices and Molecular Insights

“…The rates of antibiotic prescription varied for different conditions, with some articles, like necrotic pulp with acute apical periodontitis and swelling, aligning with guidelines, while in others, there were deviations from recommended practices. This finding underscores the importance of educational initiatives for promoting rational antibiotic use in dental practice and combatting antibiotic resistance [18,38,47,86].…”

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

“…The risk of bias was evaluated for each study (Table 3). Twenty-three studies were classified as high risk of bias [13,[16][17][18][19][20]46,49,50,[52][53][54]56,58,59,61,[66][67][68][69]71,74,76], thirteen had a moderate risk of bias [15,48,55,57,60,[63][64][65]70,72,73,75,77], and three studies reported low risk of bias [47,51,62]. The sum of points assigned to the 39 included studies was 170 out of a possible maximum of 312.…”

How decisions are made: Antibiotic stewardship in dentistry

“…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.…”