Knowledge levels of graduate and trainee dentists on antibiotic use in endodontics

Abstract

Objective: The aim of this study was to compare and evaluate the level of knowledge of dentists and dental students about the rational use of antibiotics (RUA), their clinical approaches when prescribing antibiotics, and student and graduate dentists. Introduction: Rational use of medicines means that patients take their medicines according to their clinical needs, in appropriate doses, for sufficient time, and at the lowest cost to themselves and society. The RUA is very important in the treatment and prevention of bacterial infections. Materials and Methods: The questionnaire, which was prepared on Google Forms for all graduate and trainee dentists in Turkey that we could reach and included questions about RUA and antibiotic use in dentists, was distributed to approximately 400 people, and 331 people returned the questionnaire. Results: Of the respondents, 52.3% were dental students, and the remaining 47.7% were dental graduates. 94.8% of the participants reported that they received information about RUA from the faculty, followed by scientific publications, the internet and social media, the Ministry of Health, relatives, spouses, and friends, professional associations, and newspapers. The majority of participants, 303 people, answered the question, 'Can inappropriate use of antibiotics increase antimicrobial resistance? The majority of participants answered yes, while the remaining 18 answered no. The majority of participants, 62.1%, thought that antibiotics were prescribed more than necessary. Only 35% of participants (110 people) correctly answered the question about antibiotics that are not suitable for use during pregnancy and breastfeeding. Conclusion: According to the results of our study, dentists have an important role to play in ensuring the RUA. Dentists should be regularly trained with updated curricula.

Keywords

• Rational antibiotic use
• dentistry
• dental trainees

Mezun ve stajyer diş hekimlerinin endodontide antibiyotik kullanım bilgi seviyeleri

Abstract

Amaç: Bu çalışmada amaç diş hekimlerinin ve diş hekimliği fakültelerinde staj yapan öğrencilerin AKK hakkında bilgi seviyelerini, antibiyotik reçete ederken klinik yaklaşımlarını, öğrenci/mezun diş hekimlerini karşılaştırmak ve değerlendirmektir. Giriş: Akılcı ilaç kullanımı; hastaların klinik ihtiyaçlarına uygun şekilde, uygun dozlarda, yeterli sürede, kendilerine ve topluma en düşük maliyette ilaçlarını almaları demektir. AAK bakteriyel enfeksiyonların tedavisinde ve önlenmesinde çok önemli bir yere sahiptir. Gereç ve Yöntem: Türkiye’deki ulaşabildiğimiz tüm mezun ve stajyer diş hekimlerine yönelik Google formlar üzerinden hazırlanan ve AAK hakkında ve antibiyotiklerin diş hekimlerinde kullanımı ile ilgili soruları içeren anket yaklaşık olarak 400 adet kişiye dağıtılmış ve 331 kişi ankete dönüş yapmıştır. Bulgular: Araştırmaya katılanların %52,3’ü stajyer diş hekimlerinden, geri kalan %47,7’si mezun diş hekimlerinden oluşmaktaydı. Katılımcıların %94,8’si AAK hakkında eğitimini fakülteden aldığını, bunu sırayla bilimsel yayınlar, internet/sosyal medya, sağlık bakanlığı, akraba/eş/dost, meslek odaları, gazete takip etmekteydi. Katılımcıların büyük bir çoğunluğu 303 kişi ‘Uygunsuz antibiyotik kullanımının antimikrobiyal direnci arttırabilir mi? Sorusuna evet, geri kalan 18 kişi hayır ve cevabını vermiştir. Katılımcıların büyük bir çoğunluğu %62,1’i gereğinden fazla antibiyotik reçete edildiğini düşünmekteydi. Gebelik ve laktasyonda kullanılması uygun olmayan antibiyotikler sorusuna verilen yanıtları yalnızca (110 kişi) %35’i doğru yanıt vermiştir. Sonuçlar: Araştırmamızın sonuçlarına göre AAK’nın sağlanabilmesinde diş hekimlerinin rolü büyüktür. Diş hekimlerinin güncellenmiş müfredatlarla eğitimlerinin düzenli olarak yapılması gerekmektedir.

Keywords

• Akılcı antibiyotik kullanımı
• diş hekimliği
• stajyer diş hekimleri

References

1. World Health Organization. The rational use of drugs Report of the Conference of Experts Nairobi, 1985. Geneva: World Health Organization; 1987, p. 321.
2. Akıcı A. Basic principles of rational drug use and antibiotics Antibiyotikler ve Klinik Kullanımlar Dergisi. 2012;1:1-13.
3. Niederman MS. Principles of appropriate antibiotic use. Int J Antimicrob Agents. 2005;26(Suppl 3):S170-175.
4. Büyüker SM. Evaluation of knowledge, attitude, and practices of midwifery department students of the faculty of health sciences about rational antibiotic use. JAMER. 2020;5(2):11-16.
5. World Health Organization, Antimicrobial Resistance Global Report on Surveillance, Switzerland, 2014.
6. World Health Organization. Prioritization of pathogens to guide discovery, research, and development of new antibiotics for drug-resistant bacterial infections, including tuberculosis, Geneva, 2017.
7. Laxminarayan R, Heymann DL. Challenges of drug resistance in the developing world. BMJ. 2012;344:e1567.
8. Kandemir S., Ergül N. Grievances in cases using antibiotics due to orodental problems and assessment of the need for antibiotics. Int Dent J. 2000;50(2):73-77.

9. Karabay O., Hosoglu S. Increased antimicrobial consumption following reimbursement reform in Turkey. J Antimicrob Chemother. 2008;61(5):1169-1171.
10. Versporten A, Bolokhovets G, Ghazaryan L, et al. Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet Infect Dis. 2014;14(5):381-387.
11. Marra F, George D, Chong M, Sutherland S, and Patrick DM Antibiotic prescribing by dentists has increased. Why? J Am Dent Assoc. 2016;147:320-327.
12. Doherty R. In the news: antibiotic resistance. Br Dent J. 2014;216:56.
13. Fluent MT, Jacobsen PL, Hicks LA, and Osap T. Considerations for responsible antibiotic use in dentistry. J Am Dent Assoc. 2016;147:683-686.
14. Bahrani-Mougeot FK, Paster BJ, Coleman S, Ashar J, Barbuto S, Lockhart PB. Diverse and novel oral bacterial species in the blood following dental procedures. J Clin Microbiol. 2008; 46(6):2129-2132.
15. Longman LP, Preston AJ, Martin MV, Wilson NH. Endodontics in the adult patient: the role of antibiotics. J Dent. 2000;28(8):539-548.
16. Matthews DC, Tabesh M. Detection of localized tooth-related factors that predispose to periodontal infections. Periodontol 2000. 2004;34:136-150.
17. Chow AW. Infections of the oral cavity, neck, and head. In: Bennet JE, Dolin R, Blaser MJ, eds. Principles and Practice of Infectious Diseases. 8th ed. Philadelphia: Elsevier, Saunders; 2015. p. 789-805.
18. Anderson R, Calder L, and Thomas DW. Antibiotic prescribing for dental conditions: general medical practitioners and dentists compared. Br Dent J. 2000;188(7):398-400.
19. Wilson WR, Gewitz M, Lockhart PB, et al. Prevention of viridans group streptococcal infective endocarditis: a scientific statement from the American Heart Association. Circulation. 2021;143(20):e963-e978.
20. Roberts RM, Bartoces M, Thompson SE, and Hicks LA. Antibiotic prescribing by general dentists in the United States, 2013. J Am Dent Assoc. 2017;148:172-178.
21. Lockhart PB, Hanson NB, Ristic H, Menezes AR, Baddour L. Acceptance among and impact on dental practitioners and patients of American Heart Association recommendations for antibiotic prophylaxis. J Am Dent Assoc. 2013;144:1030-1035.
22. Chopra R, Merali R, Paolinelis G, Kwok J. An audit of antimicrobial prescribing in an acute dental care department. Prim Dent J. 2014; 3:24-29.
23. Aydn M, Koyuncuolu CZ, Klboz MM, Akıncı A. Diş Hekimliğinde akılcı antibiyotik kullanımı. Turkiye Klinikleri J Dental Sci. 2017;23(1):33-47
24. Mazinska B., Hryniewicz W. Polish physicians’ attitudes towards antibiotic prescription and antimicrobial resistance. Pol J Microbiol. 2017;66:309-319.
25. Minen MT, Duquaine D, Marx MA, Weiss D. A survey of the knowledge, attitudes, and beliefs of medical students concerning antimicrobial use and resistance. Microbial Drug Resistance. 2010;16:285-289.
26. Agnihotry A, Fedorowicz Z, Van Zuuren EJ, et al., Antibiotic use for irreversible pulpitis. Cochrane Database Syst Rev. 2016;17:2.
27. DarOdeh NS, AbuHammad OA, Khraisat AS, El Maaytah MA, Shehabi A. An analysis of therapeutic adult antibiotic prescriptions issued by dental practitioners in Jordan. Chemotherapy. 2008;54:17‐22.
28. Durkin MJ, Hsueh K, Sallah YH, et al. An evaluation of dental antibiotic prescribing practices in the United States. J Am Dent Assoc. 2017;148:878-886.
29. Güngör A, Çuhacı Çakır B, Yalçın H, Çakır HT, Karauzun A. Çocuklarda antibiyotik kullanımı ile ilgili ebeveynlerin tutum ve davranışlarının değerlendirilmesi. Türkiye Çocuk Hast Derg. 2019;3:202-206.
30. Doshi A, Asawa K, Bhat N, et al. Knowledge and practices of Indian dental students regarding the prescription of antibiotics and analgesics. Clujul Medical (1957). 2017;90(4):431-437.