Attitude of dentists towards the prescription of antibiotics in dental teaching hospitals of peshawar, pakistan: should we be concerned?

Shaina Zaman; Syed Imran Gilani; Siddiq Yousufi; Yasir Israr

doi:10.17126/joralres.2022.016

Shaina Zaman Community & Preventive Dentistry, Sardar Begum Dental College & Hospital, Peshawar, Pakistan.
Syed Imran Gilani Community & Preventive Dentistry, Sardar Begum Dental College & Hospital, Peshawar, Pakistan.
Siddiq Yousufi Department of Orthodontics, Khyber College of Dentistry. Peshawar, Pakistan.
Yasir Israr Department of Orthodontics, Sardar Begum Dental College & Hospital Peshawar, Pakistan.

DOI: https://doi.org/10.17126/joralres.2022.016

Abstract

Objetive: The purpose of this study was to perform a comprehensive, multifaceted assessment of the attitudes of dentists and the dominant factors influencing their decisions regarding antibiotic prescription guidelines and applications in the dental teaching hospitals of Peshawar, Pakistan.
Material and Methods: A questionnaire was distributed to 250 dental practitioners working in the four main teaching dental hospitals in Peshawar. Dental practitioners were asked to provide answers to parameters influencing their decision towards the need to prescribe antibiotics. The questionnaire further aimed to evaluate how aware the dental clinicians were of antibiotic prophylaxis guidelines and whether they considered themselves adequately trained and confident while prescribing the said medications.
Results: Out of the 250 questionnaires sent to the practitioners, 219 (88%) forms were returned. From the total, 109 (49.8%) of the respondents were males, and 23% of the dentists were found to prescribe antibiotics to their patients upon their insistence and antibiotic selection was found to be done based on the patient’s socio-economic status. A considerable percentage of the respondents (71%) preferred to rely on an expert opinion from their seniors or professors for prescribing the correct antibiotics while 30% of the respondents were found to prescribe them empirically. The survey further explored the dental practitioners’ knowledge on calculating the dose of the selected antibiotic based on a patient’s height and weight where only 19% of the respondents were found to present with some factual knowledge. The questionnaire also reviewed the dental practitioners’ awareness regarding antibiotic prophylaxis guidelines; 72% responded positively, 42% admitted to not using the guidelines in their routine clinical practice while 84% of the respondents confirmed unawareness towards the use of any guidelines.
Conclusion: There seems to be a clear defect in the education and awareness of dentists concerning antibiotic guidelines influencing their attitudes and this study highlights the importance of gauging the severity of this problem.

References

[1]. Lewis MA. Why we must reduce dental prescription of antibiotics: European Union Antibiotic Awareness Day. Br Dent J. 2008;205(10):537-8. doi: 10.1038/sj.bdj.2008.984. PMID: 19023306.

[2]. 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;6:301-6. doi: 10.2147/tcrm.s9736. PMID: 20668712; PMCID: PMC2909496.

[3]. Kudiyirickal MG, Hollinshead F. Antimicrobial prescribing practice by dentists: a study from two primary care centres in UK. Minerva Stomatol. 2011;60(10):495-500. PMID: 22082854.

[4]. Lisboa SM, Silva E. Errors in Antibiotic Therapy: Study with Dentist's Prescriptions in a Large Brazilian City. Pesqui Bras Odontopediatria Clin Integr. 18(1):e4003. doi: 10.4034/PBOCI.2018.181.47

[5]. Roy KM, Bagg J. Antibiotic prescribing by general dental practitioners in the Greater Glasgow Health Board, Scotland. Br Dent J. 2000;188(12):674-6. doi: 10.1038/sj.bdj.4800574. PMID: 11022382.

[6]. Al-Haroni M, Skaug N. Incidence of antibiotic prescribing in dental practice in Norway and its contribution to national consumption. J Antimicrob Chemother. 2007;59(6):1161-6. doi: 10.1093/jac/dkm090. PMID: 17446241.

[7]. Zakri NI, Alshehri NM, Shebli AN. Antibiotic Practicing Habits, Knowledge and Attitude toward Education about Antibiotics among Dentists in Jazan City. EJHM. 2018; 72 (3):4207-4217

[8]. Zahabiyoun S, Sahabi M, Kharazi MJ. Improving Knowledge of General Dental Practitioners on Antibiotic Prescribing by Raising Awareness of the Faculty of General Dental Practice (UK) Guidelines. J Dent (Tehran). 2015;12(3):171-6. PMID: 26622268; PMCID: PMC4663305.

[9]. Vessal G, Khabiri A, Mirkhani H, Cookson BD, Askarian M. Study of antibiotic prescribing among dental practitioners in Shiraz, Islamic Republic of Iran. East Mediterr Health J. 2011;17(10):763-9. PMID: 22256411.

[10]. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, Vlieghe E, Hara GL, Gould IM, Goossens H, Greko C, So AD, Bigdeli M, Tomson G, Woodhouse W, Ombaka E, Peralta AQ, Qamar FN, Mir F, Kariuki S, Bhutta ZA, Coates A, Bergstrom R, Wright GD, Brown ED, Cars O. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013;13(12):1057-98. doi: 10.1016/S1473-3099(13)70318-9. Erratum in: Lancet Infect Dis. 2014;14(1):11. Erratum in: Lancet Infect Dis. 2014;14(3):182. PMID: 24252483.

[11]. Antibiotic resistance: long-term solutions require action now. The Lancet. Infectious Diseases 2013.

[12]. Halboub E, Alzaili A, Quadri MF, Al-Haroni M, Al-Obaida MI, Al-Hebshi NN. Antibiotic Prescription Knowledge of Dentists in Kingdom of Saudi Arabia: An Online, Country-wide Survey. J Contemp Dent Pract. 2016;17(3):198-204. doi: 10.5005/jp-journals-10024-1827. PMID: 27207198.

[13]. Al Khuzaei NM, Assery MK, Al Rahbeni T, Al Mansoori M. Knowledge of antibiotics among dentists in Saudi Arabia. J In Oral Health. 2017; 9(2):71-80.

[14]. Konde S, Jairam LS, Peethambar P, Noojady SR, Kumar NC. Antibiotic overusage and resistance: A cross-sectional survey among pediatric dentists. J Indian Soc Pedod Prev Dent. 2016;34(2):145-51. doi: 10.4103/0970-4388.180444. PMID: 27080965.

[15]. Yang K, Wu D, Tan F, Shi S, Guo X, Min Q, Zhang X, Cheng H. Attitudes and perceptions regarding antimicrobial use and resistance among medical students in Central China. Springerplus. 2016;5(1):1779. doi: 10.1186/s40064-016-3454-0. PMID: 27795921; PMCID: PMC5061672.

[16]. Rubinstein E. Short antibiotic treatment courses or how short is short? Int J Antimicrob Agents. 2007;30 Suppl 1:S76-9. doi: 10.1016/j.ijantimicag.2007.06.017. Epub 2007 Sep 7. PMID: 17826038.

[17]. Epstein JB, Chong S, Le ND. A survey of antibiotic use in dentistry. J Am Dent Assoc. 2000;131(11):1600-9. doi: 10.14219/jada.archive.2000.0090. PMID: 11103580.

[18]. 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. doi: 10.1097/00004770-200205000-00012. PMID: 12026927.

[19]. Kuriyama T, Absi EG, Williams DW, Lewis MA. An outcome audit of the treatment of acute dentoalveolar infection: impact of penicillin resistance. Br Dent J. 2005;198(12):759-63; discussion 754; quiz 778. doi: 10.1038/sj.bdj.4812415. PMID: 15980845

[20]. Robson ML. 'Short-course high-dosage amoxycillin in the treatment of acute dento-alveolar abscess'. Br Dent J. 1986;161(12):434. doi: 10.1038/sj.bdj.4805999. PMID: 3467760.

[21]. Paterson SA, Curzon ME. The effect of amoxycillin versus penicillin V in the treatment of acutely abscessed primary teeth. Br Dent J. 1993;174(12):443-9. doi: 10.1038/sj.bdj.4808195. PMID: 8518048.

[22]. Martin MV, Longman LP, Hill JB, Hardy P. Acute dentoalveolar infections: an investigation of the duration of antibiotic therapy. Br Dent J. 1997;183(4):135-7. doi: 10.1038/sj.bdj.4809444. PMID: 9293130.