KNOWLEDGE AND PATTERNS OF ANTIBIOTIC PRESCRIPTION
AMONG DENTAL PRACTITIONERS IN HAIL, SAUDI ARABIA
256
tests, inappropriate duration, lack of guidelines
and patients’ demand and expectations.
In this study, all descriptive data were projected as
frequencies and percentages and compared using
chi-squared test, while quantitative data were
presented as means and standard deviations (SD)
and compared using t-test.
3. Results
A hundred and one completed questionnaires
were considered valid. Any questionnaire with
missing or insufficient data were excluded. The
response rate was 67%. Males represented 85.1%
of the respondents, while females represented
14.9%. The demographic and professional
characteristics of the respondents are shown in
Table 1. Most of the participants were general
practitioners or interns (66.3%), specialists (30.7%)
and only a few were consultants (3%). Nearly 60%
of the participants practiced dentistry for more
than 5 years.
Indications for antibiotic prescription in relation
to the clinical signs and symptoms and general
considerations by the practicing dental surgeons
are demonstrated in Table 2. Most of the dental
practitioners would prescribe antibiotics if there
is a sign of fever (86.1%), swelling causing eye
closure (90.1%) or diffuse swelling (75.2%).
A considerable percentage would prescribe
antibiotics for a localized fluctuant swelling
(55.4%). Patients presented with difficulty in
swallowing would be given antibiotics by 56.4%
of the participant dental surgeons. A significant
percentage (52.2%) of dental practitioners would
prescribe antibiotics postoperatively to prevent
potential complications. In cases where the
diagnosis is inconclusive or a decision to postpone
the treatment has been taken, 44.6% and 75.2%
of the participants would prescribe antibiotics
respectively.
Table 3 demonstrates the patterns of antibiotic
prescription by the participants for the clinically
diagnosed conditions. The table reveals
diverse variation among the respondents. The
respondents would consider antibiotic therapy
for pericoronitis, cellulitis and trismus by 68.3%,
89.1% and 40.6% respectively. A large percentage
of the respondents (73.4%) would still prescribe
antibiotics for surgical extraction, whereas 34.7%
of the respondents would consider the same for
routine extraction. Treatment of dry socket by
antibiotics is a choice of 48.5% of the respondents.
Acute periapical infection and acute pulpitis both
are considered for antibiotic therapy by 57.4% and
38.6% of the respondents, respectively.
Dental infection may be manifested as maxillary
sinusitis. About 67% of the dental professionals
would prescribe antibiotics for such conditions.
Substantial percentages of dental surgeons
(70.3%) and (60.4%) would use antibiotics
in treatment of periodontal abscesses and
ulcerative gingivitis, respectively. Nearly 52% of
the respondents are inclined to use antibiotics in
treatment of chronic periodontitis. About 89% of
the respondents would prescribe antibiotics for
cellulitis and 68.3% for pericoronitis cases. Patients
with trismus would be prescribed antibiotics by
approximately 41% of the dental surgeons. Post
root canal treatment apical surgeries are common
procedures. Antibiotic therapy is considered
for apicectomy by 65.3% of the respondents.
A considerable percentage of dental surgeons
(61.4%) would prescribe antibiotics for root canal
surgery postoperatively, whereas 41.6% would do
the same preoperatively.
Less than 24% of the dental surgeons would
probably prescribe antibiotics for scaling and
polishing, direct pulp capping and indirect pulp
capping cases. Antibiotic therapy is considered
by 56.4% of the respondents in case of teeth
replantation.
Table 4 indicates the motivation for using certain
antibiotics in treatment of specific clinical conditions.
Out of the 6 listed antibiotics, amoxicillin remains
the drug of choice in management of all clinical
conditions. Probably, amoxicillin-clavulanate is
the second drug of choice after amoxicillin in
treatment of cellulitis. The respondents are not
inclined to use a combination of antibiotics in
their routine dental treatments. The table shows
that tetracycline and cephalosporins were scarcely
prescribed by the dental surgeons.
The study has assessed the dental practitioners’
opinions regarding the contributing factors in
development of antibiotic resistance (Fig. 1).
More than 65% of the respondents thought that
wide spread use of antibiotics is a very important
contributing factor in development of antibiotic
resistance. Inappropriate antibiotic course
duration was rated as the second among the very
important contributing factors.
Moreover, about 52% of the respondents thought
that use of broad spectrum antibiotics and lack of
Table 1. Demographic and professional characteristics of
practicing dental practitioners.
Variable
n (%)
Gender:
Male 86 (85.1)
Female 15 (14.9)
Age (years):
20-29 28 (27.7)
30-39 35 (34.7)
40-49 32 (31.7)
50-59 06 (05.9)
Professional rank:
General practitioner/Intern 67 (66.3)
Specialist 31 (30.7)
Consultant 03 (03.0)
Years in practice:
< 5 years 41 (40.6)
> 5 years 60 (59.4)
Stoma Edu J. 2017;4(4): 254-263
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