Türkiye'deki Diş Hekimlerinin Antibiyotik ve Profilaksi Bilgilerinin Değerlendirilmesi
Yıl 2023,
Cilt: 10 Sayı: 3, 576 - 582, 25.12.2023
Gökhan Gürses
,
Rabia Gür
,
Ahmet Aktı
,
Hasan Küçükkolbaşı
,
Ercan Durmuş
Öz
Introduction: Inappropriately prescribed antibiotics accelerate the formation of antibiotic-resistant bacteria. This circumstance creates a problematic situation in terms of public health. This study aims to measure dentists' antibiotic/prophylaxis knowledge and awareness of antibiotic resistance in Turkey based on two case scenarios.
Materials Methods: Dentists in Turkey are invited by open invitation posts on various social media applications for our twelve-question online survey. The scoring was shaped based on answers to measure antibiotic/prophylaxis knowledge. The collected data were statistically analyzed by SPSS Statistics 22.
Results: 321 participants answered all questions included in the study. The statistical analyses showed a significant difference in the evaluations according to gender, title, graduation time, and workplace.
Conclusion: Inappropriate antibiotic prescription by dentists is common in Turkey. Dentists should receive more undergraduate lessons, and taking reminder antibiotic courses at regular intervals after graduation can contribute to keeping their knowledge up to date.
Kaynakça
- 1. Robles Raya P, Javierre Miranda AP, Moreno Millán N, Mas Casals A, de Frutos Echániz E, Morató Agustí ML. [Management of odontogenic infections in Primary Care: Antibiotic?]. Aten Primaria. 2017 Dec;49(10):611–8.
- 2. Flynn TR. Part IV, Chapter 16, Principles of Management and Prevention of Odontogenic Infections. In: James R. Hupp, Edward Ellis III, Myron R. Tucker, editor. CONTEMPORARY ORAL AND MAXILLOFACIAL SURGERY. Elsevier; 2013. p. 296–319.
- 3. Stein K, Farmer J, Singhal S, Marra F, Sutherland S, Quiñonez C. The use and misuse of antibiotics in dentistry: A scoping review. The Journal of the American Dental Association. 2018 Oct 1;149(10):869–84.e5.
- 4. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017 Jun 20;135(25):e1159–95.
- 5. Baddour LM, Wilson WR, Bayer AS, Fowler VG, Tleyjeh IM, Rybak MJ, et al. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications. Circulation. 2015 Oct 13;132(15):1435–86.
- 6. Sollecito TP, Abt E, Lockhart PB, Truelove E, Paumier TM, Tracy SL, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners--a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2015 Jan;146(1):11–6.e8.
- 7. Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019 Jan;19(1):56–66.
- 8. Hawkey PM. The growing burden of antimicrobial resistance. J Antimicrob Chemother. 2008 Sep;62 Suppl 1:i1–9.
- 9. Organization WH, Others. Antimicrobial resistance and primary health care [Internet]. World Health Organization; 2018. Available from: https://apps.who.int/iris/bitstream/handle/10665/326454/WHO-HIS-SDS-2018.56-eng.pdf
- 10. Rachael England. Antibiotic stewardship in dentistry: Adopted by the General Assembly: September 2019, San Francisco, United States of America. Int Dent J. 2020 Feb;70(1):9–10.
- 11. Kerr I, Reed D, Brennan AM, Eaton KA. An investigation into possible factors that may impact on the potential for inappropriate prescriptions of antibiotics: a survey of general dental practitioners’ approach to treating adults with acute dental pain. Br Dent J [Internet]. 2021 May 27; Available from: http://dx.doi.org/10.1038/s41415-021-3008-x
- 12. Cronbach LJ. Coefficient alpha and the internal structure of tests [Internet]. Vol. 16, Psychometrika. 1951. p. 297–334. Available from: http://dx.doi.org/10.1007/bf02310555
- 13. Herman BC. The Influence of Global Warming Science Views and Sociocultural Factors on Willingness to Mitigate Global Warming [Internet]. Vol. 99, Science Education. 2015. p. 1–38. Available from: http://dx.doi.org/10.1002/sce.21136
- 14. 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 amongst Spanish oral surgeons. Int Endod J. 2010 Apr;43(4):342–50.
- 15. Agnihotry A, Thompson W, Fedorowicz Z, van Zuuren EJ, Sprakel J. Antibiotic use for irreversible pulpitis [Internet]. Vol. 2019, Cochrane Database of Systematic Reviews. 2019. Available from: http://dx.doi.org/10.1002/14651858.cd004969.pub5
- 16. Deniz‐Sungur D, Aksel H, Karaismailoglu E, Sayin TC. The prescribing of antibiotics for endodontic infections by dentists in Turkey: a comprehensive survey [Internet]. Vol. 53, International Endodontic Journal. 2020. p. 1715–27. Available from: http://dx.doi.org/10.1111/iej.13390
- 17. Gutiérrez JL, Bagán JV, Bascones A, Llamas R, Llena J, Morales A, et al. Consensus document on the use of antibiotic prophylaxis in dental surgery and procedures. Med Oral Patol Oral Cir Bucal. 2006 Mar 1;11(2):E188–205.
- Nabavizadeh MR, Sahebi S, Nadian I. Antibiotic prescription for endodontic treatment: general dentist knowledge + practice in shiraz. Iran Endod J. 2011 May 15;6(2):54–9.
- 19. Germack M, Sedgley CM, Sabbah W, Whitten B. Antibiotic Use in 2016 by Members of the American Association of Endodontists: Report of a National Survey. J Endod. 2017 Oct;43(10):1615–22.
- 20. Huxhagen KJ, McCullough M. Therapeutic Guidelines: Oral and Dental [Internet]. Vol. 34, Australian Prescriber. 2011. p. 63–6. Available from: http://dx.doi.org/10.18773/austprescr.2011.040
- 21. Palmer NO, Martin MV, Pealing R, Ireland RS. An analysis of antibiotic prescriptions from general dental practitioners in England. J Antimicrob Chemother. 2000 Dec;46(6):1033–5.
- 22. Salako NO, Rotimi VO, Adib SM, Al-Mutawa S. Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait. J Dent. 2004 Sep;32(7):503–9.
- 23. Ocek Z, Sahin H, Baksi G, Apaydin S. Development of a rational antibiotic usage course for dentists. Eur J Dent Educ. 2008 Feb;12(1):41–7.
- 24. Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, et al. European Society of Endodontology position statement: the use of antibiotics in endodontics. Int Endod J. 2018 Jan;51(1):20–5.
- 25. Keenan JV, Farman AG, Fedorowicz Z, Newton JT. A Cochrane systematic review finds no evidence to support the use of antibiotics for pain relief in irreversible pulpitis. J Endod. 2006 Feb;32(2):87–92.
- 26. Swift JQ, Gulden WS. Antibiotic therapy—managing odontogenic infections [Internet]. Vol. 46, Dental Clinics of North America. 2002. p. 623–33. Available from: http://dx.doi.org/10.1016/s0011-8532(02)00031-9
- 27. Mainjot A, D’Hoore W, Vanheusden A, Van Nieuwenhuysen JP. Antibiotic prescribing in dental practice in Belgium. Int Endod J. 2009 Dec;42(12):1112–7.
- 28. Abbott P, Dowden J, Goss AN, McCullough M, Matthews J, Pope J, et al. Oral and Dental. 2007; Available from: https://research.monash.edu/en/publications/oral-and-dental
- 29. Rechenberg DK, Held U, Burgstaller JM, Bosch G, Attin T. Pain levels and typical symptoms of acute endodontic infections: a prospective, observational study. BMC Oral Health. 2016 May 27;16(1):61.
- 30. Worldwide pattern of antibiotic prescription in endodontic infections. Br Dent J. 2017 Nov 10;223(9):692.
- 31. Wojkowska-Mach J, Godman B, Glassman A, Kurdi A, Pilc A, Rozanska A, et al. Antibiotic consumption and antimicrobial resistance in Poland; findings and implications. Antimicrob Resist Infect Control. 2018 Nov 15;7:136.
- 32. Gemmell A, Stone S, Edwards D. Investigating acute management of irreversible pulpitis: a survey of general dental practitioners in North East England. Br Dent J. 2020 Apr;228(7):521–6.
- 33. Tulip DE, Palmer NOA. A retrospective investigation of the clinical management of patients attending an out of hours dental clinic in Merseyside under the new NHS dental contract. Br Dent J. 2008 Dec 20;205(12):659–64; discussion 648.
- 34. Thompson W, Tonkin-Crine S, Pavitt SH, McEachan RRC, Douglas GVA, Aggarwal VR, et al. Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care [Internet]. Vol. 74, Journal of Antimicrobial Chemotherapy. 2019. p. 2139–52. Available from: http://dx.doi.org/10.1093/jac/dkz152
- 35. Owatz CB, Khan AA, Schindler WG, Schwartz SA, Keiser K, Hargreaves KM. The incidence of mechanical allodynia in patients with irreversible pulpitis. J Endod. 2007 May;33(5):552–6.
- 36. Lolignier S, Eijkelkamp N, Wood JN. Mechanical allodynia [Internet]. Vol. 467, Pflügers Archiv - European Journal of Physiology. 2015. p. 133–9. Available from: http://dx.doi.org/10.1007/s00424-014-1532-0
- 37. Virdee SS, Bhakta S, Seymour D. Effective anaesthesia of the acutely inflamed pulp: part 2. Clinical strategies. Br Dent J. 2015 Nov 13;219(9):439–45.
- 38. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of Infective Endocarditis [Internet]. Vol. 116, Circulation. 2007. p. 1736–54. Available from:http://dx.doi.org/10.1161/circulationaha.106.183095
- 39. Šutej I, Par M, Lepur D, Peroš K, Pintarić H, Alajbeg I, et al. Dentists’ practice and compliance with current guidelines of infective endocarditis prophylaxis- National survey study. J Clin Exp Dent. 2021 Jul;13(7):e648–52.
- 40. Ryalat S, Hassona Y, Al-Shayyab M, Abo-Ghosh M, Sawair F. Dentists’ knowledge and practice regarding prevention of infective endocarditis. Eur J Dent. 2016 Oct;10(4):480–5.
- 41. Homaj M, Szotek M, Sabatowski K, Zabojszcz M, Loster BW, Sadowski M, et al. Prevention of infective endocarditis during dental extractions among Polish dentists - a contemporary nationwide survey. Folia Med Cracov. 2019;59(4):5–12.
- 42. Nomura R, Kokomoto K, Ohara T, Nakatani S, Ooshima T, Nakano K. Current knowledge among Japanese experienced general dentists regarding prevention of infective endocarditis. Odontology. 2018 Jul;106(3):297–305.
- 43. Thornhill MH, Gibson TB, Cutler E, Dayer MJ, Chu VH, Lockhart PB, et al. Antibiotic Prophylaxis and Incidence of Endocarditis Before and After the 2007 AHA Recommendations [Internet]. Vol. 72, Journal of the American College of Cardiology. 2018. p. 2443–54. Available from: http://dx.doi.org/10.1016/j.jacc.2018.08.2178
The Evaluation of Dentist’s Knowledge of Antibiotics and Prophylaxis in Turkey
Yıl 2023,
Cilt: 10 Sayı: 3, 576 - 582, 25.12.2023
Gökhan Gürses
,
Rabia Gür
,
Ahmet Aktı
,
Hasan Küçükkolbaşı
,
Ercan Durmuş
Öz
Amaç: Uygun olmayan şekilde reçete edilen antibiyotikler, antibiyotiğe dirençli bakterilerin oluşumunu hızlandırır. Bu durum halk sağlığı açısından olumsuz bir durum yaratmaktadır. Bu çalışma, diş hekimlerinin Türkiye'de antibiyotik direnci konusundaki antibiyotik/profilaksi bilgi ve farkındalıklarını iki olgu senaryosuna dayanarak ölçmeyi amaçlamaktadır.
Gereç ve Yöntemler: Türkiye'deki diş hekimleri, on iki soruluk çevrimiçi anketimiz için çeşitli sosyal medya uygulamalarında açık davet gönderileri ile davet edilmişlerdir. Puanlama, antibiyotik/profilaksi bilgisini ölçmeye yönelik cevaplara göre şekillendirilmiştir. Toplanan veriler SPSS Statistics 22 tarafından istatistiksel olarak analiz edilmiştir.
Bulgular: 321 katılımcı çalışmaya dahil olan tüm soruları yanıtladı. İstatistiksel analizler antibiyotik ve profilaksi bilgisi baz alındığnda; cinsiyet, unvan, mezuniyet zamanı ve işyerine göre yapılan değerlendirmelerde anlamlı farklılık göstermiştir.
Sonuçlar: Türkiye'de diş hekimleri tarafından uygunsuz antibiyotik reçetesi yaygındır. Diş hekimleri daha fazla lisans dersi almalı ve mezun olduktan sonra düzenli aralıklarla hatırlatma antibiyotik dersleri alması bilgilerini güncel tutmaya katkıda bulunabilir.
Anahtar kelimeler: antibiyotik bilgisi, antibiyotik profilaksisi, antibiyotik direnci, diş hekimliği, çevrimiçi anket
Kaynakça
- 1. Robles Raya P, Javierre Miranda AP, Moreno Millán N, Mas Casals A, de Frutos Echániz E, Morató Agustí ML. [Management of odontogenic infections in Primary Care: Antibiotic?]. Aten Primaria. 2017 Dec;49(10):611–8.
- 2. Flynn TR. Part IV, Chapter 16, Principles of Management and Prevention of Odontogenic Infections. In: James R. Hupp, Edward Ellis III, Myron R. Tucker, editor. CONTEMPORARY ORAL AND MAXILLOFACIAL SURGERY. Elsevier; 2013. p. 296–319.
- 3. Stein K, Farmer J, Singhal S, Marra F, Sutherland S, Quiñonez C. The use and misuse of antibiotics in dentistry: A scoping review. The Journal of the American Dental Association. 2018 Oct 1;149(10):869–84.e5.
- 4. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017 Jun 20;135(25):e1159–95.
- 5. Baddour LM, Wilson WR, Bayer AS, Fowler VG, Tleyjeh IM, Rybak MJ, et al. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications. Circulation. 2015 Oct 13;132(15):1435–86.
- 6. Sollecito TP, Abt E, Lockhart PB, Truelove E, Paumier TM, Tracy SL, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners--a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2015 Jan;146(1):11–6.e8.
- 7. Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019 Jan;19(1):56–66.
- 8. Hawkey PM. The growing burden of antimicrobial resistance. J Antimicrob Chemother. 2008 Sep;62 Suppl 1:i1–9.
- 9. Organization WH, Others. Antimicrobial resistance and primary health care [Internet]. World Health Organization; 2018. Available from: https://apps.who.int/iris/bitstream/handle/10665/326454/WHO-HIS-SDS-2018.56-eng.pdf
- 10. Rachael England. Antibiotic stewardship in dentistry: Adopted by the General Assembly: September 2019, San Francisco, United States of America. Int Dent J. 2020 Feb;70(1):9–10.
- 11. Kerr I, Reed D, Brennan AM, Eaton KA. An investigation into possible factors that may impact on the potential for inappropriate prescriptions of antibiotics: a survey of general dental practitioners’ approach to treating adults with acute dental pain. Br Dent J [Internet]. 2021 May 27; Available from: http://dx.doi.org/10.1038/s41415-021-3008-x
- 12. Cronbach LJ. Coefficient alpha and the internal structure of tests [Internet]. Vol. 16, Psychometrika. 1951. p. 297–334. Available from: http://dx.doi.org/10.1007/bf02310555
- 13. Herman BC. The Influence of Global Warming Science Views and Sociocultural Factors on Willingness to Mitigate Global Warming [Internet]. Vol. 99, Science Education. 2015. p. 1–38. Available from: http://dx.doi.org/10.1002/sce.21136
- 14. 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 amongst Spanish oral surgeons. Int Endod J. 2010 Apr;43(4):342–50.
- 15. Agnihotry A, Thompson W, Fedorowicz Z, van Zuuren EJ, Sprakel J. Antibiotic use for irreversible pulpitis [Internet]. Vol. 2019, Cochrane Database of Systematic Reviews. 2019. Available from: http://dx.doi.org/10.1002/14651858.cd004969.pub5
- 16. Deniz‐Sungur D, Aksel H, Karaismailoglu E, Sayin TC. The prescribing of antibiotics for endodontic infections by dentists in Turkey: a comprehensive survey [Internet]. Vol. 53, International Endodontic Journal. 2020. p. 1715–27. Available from: http://dx.doi.org/10.1111/iej.13390
- 17. Gutiérrez JL, Bagán JV, Bascones A, Llamas R, Llena J, Morales A, et al. Consensus document on the use of antibiotic prophylaxis in dental surgery and procedures. Med Oral Patol Oral Cir Bucal. 2006 Mar 1;11(2):E188–205.
- Nabavizadeh MR, Sahebi S, Nadian I. Antibiotic prescription for endodontic treatment: general dentist knowledge + practice in shiraz. Iran Endod J. 2011 May 15;6(2):54–9.
- 19. Germack M, Sedgley CM, Sabbah W, Whitten B. Antibiotic Use in 2016 by Members of the American Association of Endodontists: Report of a National Survey. J Endod. 2017 Oct;43(10):1615–22.
- 20. Huxhagen KJ, McCullough M. Therapeutic Guidelines: Oral and Dental [Internet]. Vol. 34, Australian Prescriber. 2011. p. 63–6. Available from: http://dx.doi.org/10.18773/austprescr.2011.040
- 21. Palmer NO, Martin MV, Pealing R, Ireland RS. An analysis of antibiotic prescriptions from general dental practitioners in England. J Antimicrob Chemother. 2000 Dec;46(6):1033–5.
- 22. Salako NO, Rotimi VO, Adib SM, Al-Mutawa S. Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait. J Dent. 2004 Sep;32(7):503–9.
- 23. Ocek Z, Sahin H, Baksi G, Apaydin S. Development of a rational antibiotic usage course for dentists. Eur J Dent Educ. 2008 Feb;12(1):41–7.
- 24. Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, et al. European Society of Endodontology position statement: the use of antibiotics in endodontics. Int Endod J. 2018 Jan;51(1):20–5.
- 25. Keenan JV, Farman AG, Fedorowicz Z, Newton JT. A Cochrane systematic review finds no evidence to support the use of antibiotics for pain relief in irreversible pulpitis. J Endod. 2006 Feb;32(2):87–92.
- 26. Swift JQ, Gulden WS. Antibiotic therapy—managing odontogenic infections [Internet]. Vol. 46, Dental Clinics of North America. 2002. p. 623–33. Available from: http://dx.doi.org/10.1016/s0011-8532(02)00031-9
- 27. Mainjot A, D’Hoore W, Vanheusden A, Van Nieuwenhuysen JP. Antibiotic prescribing in dental practice in Belgium. Int Endod J. 2009 Dec;42(12):1112–7.
- 28. Abbott P, Dowden J, Goss AN, McCullough M, Matthews J, Pope J, et al. Oral and Dental. 2007; Available from: https://research.monash.edu/en/publications/oral-and-dental
- 29. Rechenberg DK, Held U, Burgstaller JM, Bosch G, Attin T. Pain levels and typical symptoms of acute endodontic infections: a prospective, observational study. BMC Oral Health. 2016 May 27;16(1):61.
- 30. Worldwide pattern of antibiotic prescription in endodontic infections. Br Dent J. 2017 Nov 10;223(9):692.
- 31. Wojkowska-Mach J, Godman B, Glassman A, Kurdi A, Pilc A, Rozanska A, et al. Antibiotic consumption and antimicrobial resistance in Poland; findings and implications. Antimicrob Resist Infect Control. 2018 Nov 15;7:136.
- 32. Gemmell A, Stone S, Edwards D. Investigating acute management of irreversible pulpitis: a survey of general dental practitioners in North East England. Br Dent J. 2020 Apr;228(7):521–6.
- 33. Tulip DE, Palmer NOA. A retrospective investigation of the clinical management of patients attending an out of hours dental clinic in Merseyside under the new NHS dental contract. Br Dent J. 2008 Dec 20;205(12):659–64; discussion 648.
- 34. Thompson W, Tonkin-Crine S, Pavitt SH, McEachan RRC, Douglas GVA, Aggarwal VR, et al. Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care [Internet]. Vol. 74, Journal of Antimicrobial Chemotherapy. 2019. p. 2139–52. Available from: http://dx.doi.org/10.1093/jac/dkz152
- 35. Owatz CB, Khan AA, Schindler WG, Schwartz SA, Keiser K, Hargreaves KM. The incidence of mechanical allodynia in patients with irreversible pulpitis. J Endod. 2007 May;33(5):552–6.
- 36. Lolignier S, Eijkelkamp N, Wood JN. Mechanical allodynia [Internet]. Vol. 467, Pflügers Archiv - European Journal of Physiology. 2015. p. 133–9. Available from: http://dx.doi.org/10.1007/s00424-014-1532-0
- 37. Virdee SS, Bhakta S, Seymour D. Effective anaesthesia of the acutely inflamed pulp: part 2. Clinical strategies. Br Dent J. 2015 Nov 13;219(9):439–45.
- 38. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of Infective Endocarditis [Internet]. Vol. 116, Circulation. 2007. p. 1736–54. Available from:http://dx.doi.org/10.1161/circulationaha.106.183095
- 39. Šutej I, Par M, Lepur D, Peroš K, Pintarić H, Alajbeg I, et al. Dentists’ practice and compliance with current guidelines of infective endocarditis prophylaxis- National survey study. J Clin Exp Dent. 2021 Jul;13(7):e648–52.
- 40. Ryalat S, Hassona Y, Al-Shayyab M, Abo-Ghosh M, Sawair F. Dentists’ knowledge and practice regarding prevention of infective endocarditis. Eur J Dent. 2016 Oct;10(4):480–5.
- 41. Homaj M, Szotek M, Sabatowski K, Zabojszcz M, Loster BW, Sadowski M, et al. Prevention of infective endocarditis during dental extractions among Polish dentists - a contemporary nationwide survey. Folia Med Cracov. 2019;59(4):5–12.
- 42. Nomura R, Kokomoto K, Ohara T, Nakatani S, Ooshima T, Nakano K. Current knowledge among Japanese experienced general dentists regarding prevention of infective endocarditis. Odontology. 2018 Jul;106(3):297–305.
- 43. Thornhill MH, Gibson TB, Cutler E, Dayer MJ, Chu VH, Lockhart PB, et al. Antibiotic Prophylaxis and Incidence of Endocarditis Before and After the 2007 AHA Recommendations [Internet]. Vol. 72, Journal of the American College of Cardiology. 2018. p. 2443–54. Available from: http://dx.doi.org/10.1016/j.jacc.2018.08.2178