Assessment of the use of antibiotics by dentists
Vurdering af tandlægernes brug af antibiotika
Baggrund
– Aktuelle teorier tyder på, at antibiotikabrug indenfor odontologi bør begrænses til specifikke profylaktiske regimer, systemiske infektioner og alvorligt immunkompromitterede patienter. Denne undersøgelse har til formål at indsamle data til at evaluere almindelige anvendelser af antibiotika af tandlæger.
Metoder
– En undersøgelse med 14 spørgsmål blev formidlet til tandlægestuderende, fakulteter og tandlæger i private praksis i foråret 2015. Spørgsmålene fokuserede på praktiserende tandlægers brug af antibiotika i profylaktiske regimer, kirurgiske og ikke-kirurgiske procedurer og behandling af dentale infek-tioner. Deltagerne blev også spurgt om efteruddannelse og fortrolighed med American Dental Association (ADA) og American Heart Association’s (AHA) anbefalinger.
Resultater
– 157 undersøgelser var besvaret med 73 % af deltagerne som tandlæger. 22 % af deltagerne rapporterede rutinemæssigt at foreskrive antibiotika til ikke-kirurgiske behandlinger, 17 % for endodontisk behandling. 66 % efter komplicerede ekstraktioner, 54 % til behandling af dentalabscesser efter ekstraktion, og 45 % ordinerer antibiotika til patienter med ledproteser. 97 % rapporterede bekendtskab med AHA og ADA’s retningslinjer, men kun 42 % følger dem.
Konklusion
– Resultaterne af denne undersøgelse viser, at de fleste tandlæger ikke vil anvende antibiotika rutinemæssigt til enkle og ikke-kirurgiske procedurer, men deres overholdelse af retningslinjerne for profylaktiske behandlinger er lav. Deltagerens mangfoldighed og deres faglige baggrund kan betragtes som afgørende faktor.
CLINICAL RELEVANCE:
When discussing antibiotic use in dentistry, both clini-cal and non-clinical factors should be considered. With today’s aging population liv-ing longer, dentists see pa-tients with more complex medical conditions and more demanding treatment needs. Although antibiotics have not always proven to be effective, they have often been used as an extra precaution. Patient expectations, time, conveni-ence and demand are other factors that may influence the dentists’ tendency towards over-prescribing antibiotics. In order to propose how to better educate the dentists for a better practice, it should be determined if the pattern of prescribing antibiotics is evidence-based or anecdotal.
Background and aim – Current theories sug-gest that antibiotic use in dentistry should be limited to specific prophylactic regimens, sys-temic infections, and severely immunocom-promised patients. This study aims to collect data to evaluate common uses of antibiotics by dentists.
Methods – A survey containing 14 questions was disseminated to dental students, faculty and dentists in private practices in spring 2015. The questions focused on practitioners’ use of antibiotics in prophylactic regimens, surgical and non-surgical procedures, and treatment of dental infections. The participants were also asked about continuing education and familiar-ity with American Dental Association (ADA) and American Heart Association (AHA) recommen-dations.
Results – 157 surveys were completed with 73% of participants being General Dentists. 22% of participants reported to routinely pre-scribe antibiotics for non-surgical treatments, 17% for endodontic therapy. 66% after compli-cated extractions, 54% for treatment of dental abscesses after extraction and 45% prescribed antibiotics for patients with previous joint re-placements. 97% reported familiarity with AHA and ADA guidelines but only 42% follow them. Conclusion – The results of this survey show most dentists would not use antibiotics rou-tinely for simple and non-surgical procedures but their adherence to the guidelines for pro-phylactic treatments is low.
Diversity of the participants and their profes-sional background can be considered as a de-termining factor.