Utilizzo degli antibiotici: risultati di un sondaggio condotto su un campione di dentisti italiani

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

“…Similar to our results, overuse and misuse of antibiotics in dentistry was registered in France [ 21 ], the USA [ 25 ], and the UK, where 37.6% of adults and the 39.0% of pediatric patients attending dental clinics for emergencies were administered antimicrobials and, in 57.4% of cases, antibiotics were prescribed even if no diagnosis was documented [ 31 , 32 , 33 , 34 ]. This is also consistent with findings from a cross-sectional study conducted in India, which revealed that 35% of dentists prescribed antibiotics prior to or instead of starting local treatment [ 31 , 32 ].…”

“…It is worth noting that 17.3% of dentists in the present survey reported administering antimicrobials to healthy patients in cases of simple tooth extractions. Similar findings were described in several other studies, indicating that dentists often overprescribe antibiotics for prophylaxis, even in healthy patients undergoing invasive dental procedures, such as surgical extractions, dental implant positioning, and endodontic procedures, without observing the relevant guidelines [ 14 , 25 ]. It should be noted that guidelines and recommendations are still lacking for immunocompromised subjects, such as those suffering from type 1 diabetes, HIV infection or AIDS, although increasingly required; thus, antibiotic prescription for prophylactic purposes is justified according to the American Dental Association [ 26 ].…”

“…In patients with a penicillin allergy, macrolides were the most frequently prescribed antibiotics (83.4%), followed by lincosamides(4.2%), as shown in Table 3 . Macrolides were also preferred by 52.9% of Italian oral implant surgeons [ 25 ], as revealed by another recent cross-sectional survey. Conversely, Baudet et al [ 21 ] found that, among French dentists, clindamycin was the most frequently prescribed antibiotic (46.7%) in patients allergic to penicillin, followed by spiramycin + metronidazole (32.2%), even though both administrations (clindamycin and a spiramycin + metronidazole fixed-dose combination) may not be appropriate for patients who are allergic to penicillin [ 26 ].…”

“…Conversely, Baudet et al [ 21 ] found that, among French dentists, clindamycin was the most frequently prescribed antibiotic (46.7%) in patients allergic to penicillin, followed by spiramycin + metronidazole (32.2%), even though both administrations (clindamycin and a spiramycin + metronidazole fixed-dose combination) may not be appropriate for patients who are allergic to penicillin [ 26 ]. Clindamycin was similarly shown to be the most prescribed antibiotic in penicillin-allergic patients in Spain (63.2%) [ 27 , 28 ] and the USA (95.4%) [ 35 , 36 ], where dentists are among the leading prescribers of antibiotics and often use broad-spectrum antibiotics for longer than necessary, even in cases in which it is not necessary or compliant with the guidelines [ 25 ].…”

Antibiotic prophylaxis habits in oral implant surgery among dentists in Italy: a cross-sectional survey

“…There is evidence showing that dental practitioners have over prescribed large numbers of systemic antibiotics and that their number has even increased in the last years [23]. In addition, a recent survey involving more than one thousand Italian dentists found that the use of systemic antibiotics is frequent and excessive [24].…”