Knowledge of Dental Students Regarding the Antibiotic Use in Children in the Management of Endodontic Infections

Year 2021, , 41 - 48, 30.04.2021

Merve Erkmen Almaz , Esma Kocaman , Tuğba Bezgin , Gözde Yıldız

https://doi.org/10.24938/kutfd.770264

Abstract

Objective: The aim of this study was to measure the knowledge of last grade students in Ankara and Kırıkkale University Faculty of Dentistry, by applying a questionnaire about the use of systemic antibiotics in endodontic infections in pediatric patients.

Material and Methods: A questionnaire, including questions about indications of antibiotics and antibiotics used in children, was answered by a total of 224 students with 155 students from Ankara University and 69 students from Kırıkkale University. The data was analyzed by descriptive statistics using the SPSS program.

Results: Two hundred and seventeen students (97.7%) completed the questionnaire and were included in the study. Of the students, 98.6% preferred amoxicillin as an antibiotic to the patient who had no medical allergy. The advised duration of antibiotic treatment was 6.4±1.6 (mean) days. Clindamycin was the first choice for children with penicillin allergy (79.3%). Respectively 1.4% and 11.9% of students reported that they would prescribe antibiotics in teeth with reversible pulpitis and irreversible pulpitis with vital pulp. Of the students, 14.3% prescribed antibiotics for irreversible pulpitis with devital pulp, and 48.8% of the students for localized dentoalveolar abscess. 96.7% of the students stated that they would prescribe antibiotics when there was a diagnosis of diffuse swelling on the affected side of the patient's face.

Conclusion: Dental students need to develop their knowledge about the use of antibiotics related to endodontic infections in pediatric patients. By identifying the cases, students should have better skills in prescribing antibiotics in pulp-periapical pathology in the undergraduate period.

Keywords

Antibiotics, children, dental infection

ÇOCUKLARDA ENDODONTİK ENFEKSİYONLARIN TEDAVİSİNDE ANTİBİYOTİK KULLANIMINA İLİŞKİN DİŞ HEKİMLİĞİ ÖĞRENCİLERİNİN BİLGİ DÜZEYLERİ

Abstract

Amaç: Bu çalışmada; çocuk hastalarda endodontik enfeksiyonlarda sistemik antibiyotik kullanımına ilişkin, Ankara Üniversitesi ve Kırıkkale Üniversitesi Diş Hekimliği Fakültesi son sınıf öğrencilerine anket uygulanarak, öğrencilerin bilgi düzeyinin ölçülmesi amaçlanmıştır.

Gereç ve Yöntemler: Ankara Üniversitesi’nden 155 öğrenci, Kırıkkale Üniversitesi’nden 69 öğrenci olmak üzere toplam 224 öğrenciye; çocuklarda kullanılan antibiyotikler ve endikasyonlarına yönelik sorular içeren anket uygulanmıştır. Anket verileri değerlendirildikten sonra veriler SPSS programı kullanılarak tanımlayıcı istatistikler ile analiz edilmiştir.

Bulgular: İki yüz on yedi (%97.7) öğrenci anketi tamamlayarak çalışmaya dahil edilmiştir. Öğrencilerin %98.6’sı medikal alerjisi olmayan çocuk hastada antibiyotik olarak amoksisilini tercih etmiştir. Önerdikleri antibiyotik tedavi süresi ortalama 6.4±1.6 gündür. Penisilin alerjisi olan çocuk hastalar için ilk tercih edilen ilaç klindamisindir (%79.3). Reversible pulpitis ve vital pulpaya sahip irreversible pulpitisli dişlerde sırasıyla öğrencilerin %1.4 ve %11.9’u antibiyotik reçete edeceklerini bildirmiştir. İrreversibl pulpitis vakalarında devital pulpaya sahip dişlerde öğrencilerin %14.3’ü, lokalize dentoalveolar apse tanısı konulan olgularda öğrencilerin %48.8’i antibiyotik reçete etmiştir. Fasial selülit ve hastanın yüzünde etkilenen bölge tarafında diffüz şişlik tanısı konulan olgularda ise öğrencilerin %96.7’si antibiyotik reçete edeceğini belirtmiştir.

Sonuç: Diş hekimliği son sınıf öğrencilerinin çocuk hastalarda endodontik enfeksiyonlarla ilgili antibiyotik kullanımında, bilgi düzeylerini geliştirmeleri gerekmektedir. Doğru vakaları teşhis ederek, öğrencilerin pulpa-periapikal patolojide antibiyotik reçeteleme konusunda daha iyi becerilere sahip olmaları eğitim döneminde sağlanmalıdır.

Keywords

Antibiyotikler, Çocuklar, dental enfeksiyon

References

• 1. Caron WP, Mousa SA. Prevention strategies for antimicrobial resistance: A systematic review of the literature. Infect Drug Resist. 2010;3(1):25-33.
• 2. Levy SB. Antibiotic resistance‑the problem intensifies. Adv Drug Deliv Rev. 2005;57(10):1446-50.
• 3. Kılıç E, Yenilmez F. Türkiye ve AB Ülkelerinde antibiyotik kullanımı, antibiyotik direnci ve dış ticaret dengesi üzerine bir değerlendirme. ESTÜDAM Halk Sağlığı Dergisi. 2019;4(1):45-54.
• 4. Dar‑Odeh NS, Abu‑Hammad OA, Al‑Omiri MK, Khraisat AS, Shehabi AA. Antibiotic prescribing practices by dentists: A review. Ther Clin Risk Manag. 2010;6(1):301-6.
• 5. Sivaraman SS, Hassan M, Pearson JM. A national survey of pediatric dentists on antibiotic use in children. Pediatr Dent. 2013;35(7):546-9.
• 6. Cherry WR, Lee JY, Shugars DA, White RP Jr, Vann WF Jr. Antibiotic use for treating dental infections in children: A survey of dentists’ prescribing practices. J Am Dent Assoc. 2012;143(1):31-8.
• 7. Jimenez-Pinzon A, Segura-Egea JJ, Poyato M, Velasco E, Rios JV. Prevalence of apical periodontitis and frequency of root-filled teeth in an adult Spanish population. Int Endod J. 2004;37(3):167-73.
• 8. Gulsahi K, Gulsahi A, Ungor M, Genc Y. Frequency of root-filled teeth and prevalence of apical periodontitis in an adult Turkish population. Int Endod J. 2008;41(1):78-85.
• 9. Peters LB, Lindeboom JA, Elst ME, Wesselink PR. Prevalence of apical periodontitis relative to endodontic treatment in an adult Dutch population: a repeatedcross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(4):523-8.
• 10. Lopez-Lopez J, Jane-Salas E, Estrugo-Devesa A, Castellanos-Cosano L, Martín-González J, Velasco-Ortega E et al. Frequency and distribution of root filled teeth and apical periodontitis in an adult population of Barcelona, Spain. Int Endod J. 2012;62(1):40-6.
• 11. Ajantha GS, Hegde V. Antibacterial drug resistance and its impact on dentistry. N Y State Dent J. 2012;78(4):38-41.
• 12. American Association of Endodontists (AAE). Accessed date: 04 April 2020: https://www.aae.org/ specialty/wp-content/uploads/sites/ 2/2017/06/ aae_ systemic-antibiotics.pdf.
• 13. Aminoshariae A, Kulild J. Evidence based recommendations for antibiotic usage for endodontic infections and pain: a systematic review. J Am Dent Assoc. 2016;147(3):186-91.
• 14. Agnihotry A, Fedorowicz Z, van Zuuren EJ, Farman AG, Al-Langawi JH. Antibiotic use for irreversible pulpitis. Cochrane Database Syst Rev. 2019;5(5):CD004969.
• 15. Segura-Egea JJ, Velasco-Ortega E, Torres-Lagares D, Velasco-Ponferrada MC, Monsalve-Guil L, Llamas-Carreras JM. Pattern of antibiotic prescription in the management of endodontic infections among Spanish oral surgeons. Int Endod J. 2010;43(4):342-50.
• 16. Segura-Egea JJ, Martin-Gonzalez J, Jimenez-Sanchez MC, Crespo-Gallardo I, Sauco-Marquez JJ, Velasco-Ortega E. Worldwide pattern of antibiotic prescription in endodontic infections. Int Dent J. 2017;67(4):197-205.
• 17. Mainjot A, D’Hoore W, Vanheusden A, Van Nieuwenhuysen JP. Antibiotic prescribing in dental practice in Belgium. Int Endod J. 2009;42(12):1112-7.
• 18. Aydın M, Koyuncuoğlu CZ, Kılboz MM, Akıcı A. Diş Hekimliğinde Akılcı Antibiyotik Kullanımı. Turkiye Klinikleri J Dental Sci. 2017;23(1):33-47.
• 19. Martín-Jiménez M, Martín-Biedma B, López-López J, Alonso-Ezpeleta O, Velasco-Ortega E, Jiménez-Sánchez MC et al. Dental students' knowledge regarding the indications for antibiotics in the management of endodontic infections. Int Endod J. 2018;51(1):118-27.
• 20. Rodríguez‐Núñez A, Cisneros‐Cabello R, Velasco‐Ortega E, Llamas‐Carreras JM, Tórres‐Lagares D, Segura‐Egea JJ. Antibiotic use by members of the Spanish endodontic society. J Endod. 2009;35(9):1198-203.
• 21. Yingling NM, Byrne BE, Hartwell GR. Antibiotic use by members of the American Association of Endodontists in the year 2000: report of a national survey. J Endod. 2002;28(5):396-404.
• 22. Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A et al. Antibiotics in Endodontics: a review. Int Endod J. 2017;50(12):1169-84.
• 23. Siqueira JF Jr, Rocas IN, Silva MG. Prevalence and clonal analysis of Porphyromonas gingivalis in primary endodontic infections. J Endod. 2008;34(11):1332-6.
• 24. Zeitoun IM, Dhanarajani PJ. Cervical cellulitis and mediastinitis caused by odontogenic infections: report of two cases and review of literature. J Oral Maxillofac Surg. 1995;53(2):203-8.