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Antibiotics
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Antibiotic Prescribing in Primary Dental Care
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Antibiotic Prescribing in Primary Dental Care

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 15 November 2024 | Viewed by 4091

Special Issue Editor

Dr. Kristina Peros

E-Mail Website
Guest Editor
Department of Pharmacology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Interests: fluorides; topical treatment; ion-releasing dental materials; recharge potential
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prescribing of antibiotics in primary dental care is a daily procedure that is well regulated by evidence-based guidelines. However, the continuous development of bacterial resistance worldwide necessitates greater efforts to improve the patterns of antibiotic prescribing by clinicians, including dentists. Primary dental care covers common oral cavity infections, as well as odontogenic and periodontal infections, requiring systemic antimicrobial therapy in addition to mechanical dental treatment.

Finding the ideal balance between indications for systemic antibiotic therapy in odontogenic infection (such as acute apical abscess with systemic involvement, the onset of a severe or spreading infection, osteomyelitis, the replantation of avulsed permanent teeth, or medically compromised patients) and the rationalization of antibiotic prescribing, using the most appropriate drug at the lowest dose necessary to obtain the best effect in the shortest period of time and at a reasonable cost, is of major interest for public health.

This Special Issue aims to provide an up-to-date insight into clinical questions concerning the prescribing of antibiotics in primary dental care, and to address antibiotic stewardship in dentistry. Particular consideration will be to given to original research, reviews, and short communications discussing more precise indications for the prescribing of antibiotics in dentistry, including laboratory and clinical diagnosis, therapeutic perspectives, rational prescribing, and the public health approach.

Dr. Kristina Peros
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • primary dental care
  • antibiotic prescribing
  • rational drug prescribing
  • antibiotic stewardship

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Published Papers (4 papers)

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Research

9 pages, 222 KiB  
Article
Antibiotic Prescribing Habits in Endodontics among Dentists in the Federation of Bosnia and Herzegovina—A Questionnaire-Based Study
by Matea Galić, Ivana Miletić, Tina Poklepović Peričić, Valentina Rajić, Nikolina Nika Većek Jurčević, Ajka Pribisalić and Ivana Medvedec Mikić
Antibiotics 2024, 13(9), 876; https://doi.org/10.3390/antibiotics13090876 - 12 Sep 2024
Viewed by 919
Abstract
Backgrounds: Antibiotics are used in endodontic treatment to control acute odontogenic infection and for prophylactic purposes. This study aimed to investigate the knowledge of dentists from the Federation of Bosnia and Herzegovina about the choice and the routes of antibiotic administration in endodontics. [...] Read more.
Backgrounds: Antibiotics are used in endodontic treatment to control acute odontogenic infection and for prophylactic purposes. This study aimed to investigate the knowledge of dentists from the Federation of Bosnia and Herzegovina about the choice and the routes of antibiotic administration in endodontics. Methods: This cross-sectional study involved dentists in Federation of Bosnia and Herzegovina health institutions. The Dental Chamber sent a twelve-question survey to members’ email addresses. They were asked about the type, dosage, indications, and side effects of antibiotics used in endodontics. The obtained data were screened and analyzed. Results: A total of 180 questionnaires were filled out. The most commonly prescribed antibiotic was amoxicillin with clavulanic acid. Pulp necrosis with symptomatic apical periodontitis, swelling, and moderately severe symptoms were the main indications for the therapeutic use of antibiotics. Amoxicillin, administered orally at 2 g 1 h before endodontic surgery for patients with bacterial endocarditis, was mostly indicated for the prophylactic use of antibiotics. Conclusions: Based on the results of this study, we can conclude that dentists from the Federation of Bosnia and Herzegovina have limited knowledge regarding antibiotic use in endodontics. Educational activities and campaigns are necessary to raise awareness about antibiotics in dental medicine in the Federation of Bosnia and Herzegovina. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
14 pages, 1202 KiB  
Article
Antibiotic Prescribing Trends in Dentistry during Ten Years’ Period—Croatian National Study
by Ivana Šutej, Krešimir Bašić, Sanja Šegović and Kristina Peroš
Antibiotics 2024, 13(9), 873; https://doi.org/10.3390/antibiotics13090873 - 12 Sep 2024
Viewed by 525
Abstract
Prescribing antibiotics is a regular part of daily dental practice. Antibiotics have a significant but a limited role in general dental practice due to the threat of emergence of antimicrobial resistance (AMR). As such, the aim of this study was to assess prescribing [...] Read more.
Prescribing antibiotics is a regular part of daily dental practice. Antibiotics have a significant but a limited role in general dental practice due to the threat of emergence of antimicrobial resistance (AMR). As such, the aim of this study was to assess prescribing trends in dental antibiotics use from 2014–2023 in Croatia. Data on antibiotic prescribing practices for this study were provided by the Croatian Health Insurance Fund. The analysis included the number of prescriptions, packages, cost, and the World Health Organization’s defined daily dose per 1000 inhabitants (DID) per day as an objective utilization for comparison. Over the 10-year period, dentists in Croatia prescribed an annual average of 357,875 antibiotic prescriptions, representing an annual average of 78.7% of all dental prescriptions. The most commonly prescribed antibiotic was the combination of amoxicillin and the beta-lactamase inhibitor clavulanic acid, which made up 58.54% of antibiotics and 46.1% of all dental prescriptions. This was followed by amoxicillin (12.61%), clindamycin (12.58%), and metronidazole (9.96%). The trend showed two discontinuations, the first for the pandemic years, and the second caused by disruption in amoxicillin production. The rise in the use of broad-spectrum antibiotics needs to be addressed and regulated to ensure patients and dentists understand that antibiotics are not a substitute for dental treatment. Dentists should always begin treatment with narrow-spectrum antibiotics regardless of possible exceptional circumstances. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
►▼ Show Figures

Figure 1

Figure 1
<p>Descriptive statistics of the most commonly prescribed antibiotics in time intervals (2014/15, 16/17, 18/19, 20/21, 22/23). Same letters (a) indicate statistically significant values for comparisons among year intervals—for clindamycin (2018/2019 compared to 2020/2021, <span class="html-italic">p</span> = 0.045) and for amoxicillin (2016/2017 compared to 2018/2019, <span class="html-italic">p</span> = 0.017). Bars denote mean value of number of prescriptions for each time interval. Error bars denote ± 1 SD. Dotted line denotes trend line—two period moving average.</p> Full article ">Figure 2
<p>Descriptive statistics of prescribed cephalosporins in time intervals (2014/15, 16/17, 18/19, 20/21, 22/23). Same letters (a, b, c) indicate statistically significant values for comparisons among year intervals—for cefalexin (2014/2015 compared to 2016/2017, <span class="html-italic">p</span> = 0.017; 2016/2017 compared to 2018/2019, <span class="html-italic">p</span> = 0.033; 2014/2015 compared to 2022/2023, <span class="html-italic">p</span> = 0.027) and for cefuroxim (2018/2019 compared to 2020/2021, <span class="html-italic">p</span> = 0.009; 2014/2015 compared to 2022/2023, <span class="html-italic">p</span> = 0.014). Ceftibuten was discontinued in 2017. Bars denote mean value of number of prescriptions for each time interval. Error bars denote ± 1 SD. Dotted line denotes trend line—two period moving average.</p> Full article ">Figure 3
<p>Descriptive statistics of antibiotics with less than 1400 prescriptions per year, in time intervals (2014/15, 16/17, 18/19, 20/21, 22/23). Same letters (a, b) indicate statistically significant values for comparisons among year intervals—for the interval 2016/2017 when compared to 2018/2019 (levofloxacin <span class="html-italic">p</span> = 0.042; sulfamethoxazole + trimethoprim <span class="html-italic">p</span> = 0.048; phenoxymethylpenicillin potassium <span class="html-italic">p</span> = 0.033; erythromycin <span class="html-italic">p</span> = 0.002), for the interval 2014/2015 when compared to 2022/20223 (sulfamethoxazole + trimethoprim <span class="html-italic">p</span> = 0.001; doxycycline <span class="html-italic">p</span> = 0.047 and erythromycin <span class="html-italic">p</span> = 0.021) and for the interval 2020/2021 when compared to 2022/2023 (claritromycin <span class="html-italic">p</span> = 0.039). Bars denote mean value of number of prescriptions for each time interval. Error bars denote ± 1 SD. Dotted line denotes trend line—two period moving average.</p> Full article ">
15 pages, 3653 KiB  
Article
Patterns of Antibiotic Prescription in Endodontic Therapy in the Republic of Croatia
by Josipa Sović, Sanja Šegović, Božidar Pavelić, Ivona Bago, Ivana Šutej and Ivan Tomašić
Antibiotics 2024, 13(7), 645; https://doi.org/10.3390/antibiotics13070645 - 12 Jul 2024
Viewed by 762
Abstract
In response to the global trend of decreasing antibiotic usage, this study aimed to evaluate the nature and frequency of antibiotic prescriptions in conjunction with endodontic therapy in Croatia and to assess the attitudes of Croatian dental practitioners towards the endodontic treatment of [...] Read more.
In response to the global trend of decreasing antibiotic usage, this study aimed to evaluate the nature and frequency of antibiotic prescriptions in conjunction with endodontic therapy in Croatia and to assess the attitudes of Croatian dental practitioners towards the endodontic treatment of patients susceptible to bacterial endocarditis. A survey questionnaire was sent to all dental practitioners in Croatia, achieving a response rate of 27%. The most frequently prescribed antibiotic was penicillin with clavulanic acid (63.4%), while standalone penicillin was less prevalent (18.6%). For patients exhibiting penicillin allergies, 90% of respondents indicated clindamycin as their preferred alternative. Antibiotics were mostly prescribed for localized acute apical abscesses without fever, followed by prophylaxis for infectious endocarditis and cellulitis. Only 1.3% of the respondents reported frequent antibiotic prescriptions without accompanying local treatment. While a substantial proportion of surveyed practitioners professed familiarity with the latest guidelines for antibiotic prophylaxis, their choice of antibiotics did not consistently reflect this claim. Most respondents conducted endodontic procedures on patients at risk of bacterial endocarditis. The findings highlight a need for targeted continuing education for dental practitioners in the Republic of Croatia, ensuring their practices align with current guidelines and global trends in antibiotic prescription. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
►▼ Show Figures

Figure 1

Figure 1
<p>General characteristics of practitioners. (<b>A</b>) Years in practice; (<b>B</b>) continuing dental education on endodontics in the last 5 years (CE); and (<b>C</b>) degree of clinical education (DCE) of the responders (Doctor of Dental Medicine; Specialist in Endodontics; Resident in Endodontics).</p> Full article ">Figure 2
<p>Effect of various factors on antibiotic prescription. (<b>A</b>) Effect of sex and years of practice of dental practitioners; (<b>B</b>) effect of continuing dental education in endodontics taken by dental practitioners in the last 5 years (CE); (<b>C</b>) effect of educational qualifications of the dental practitioner; (<b>D</b>) effect of office organization; (<b>E</b>) effect of office type; (<b>F</b>) effect of rubber dam use; (<b>G</b>) effect of “single-visit endodontic treatment”. (Significance codes used are: ** for 0.01, * for 0.05, dot for 0.1. Slopes are designated with corresponding number of stripes whereas a dotted stripe corresponds to a dot, i.e., to 0.1 significance).</p> Full article ">Figure 3
<p>Categorization of dentists prescribing antibiotics for various endodontic etiologies according to sex and educational qualifications. DDM, Doctor of Dental Medicine without specialization; EndoS, Specialist in Endodontics; EndoR, Resident in Endodontics.</p> Full article ">Figure 4
<p>Proportion of dentists prescribing antibiotics without performing treatment on the affected tooth. (<b>A</b>) Effect of sex and years of practice of dental practitioners on antibiotic prescription; (<b>B</b>) effect of continuing dental education on endodontics taken by dental practitioners in the last 5 years (CE) on antibiotic prescription; (<b>C</b>) effect of educational qualifications of the dental practitioner on antibiotic prescription; (<b>D</b>) effect of office organization on antibiotic prescription; (<b>E</b>) effect of office type on antibiotic prescription; (<b>F</b>) effect of rubber dam use on antibiotic prescription. HC, health center; Conc, dental clinic with concession contract; Priv, private clinic; PrivSA, private clinic with a health fund contract; Poly, dental polyclinic; SDM, school of dental medicine; DDM, Doctor of Dental Medicine without specialization; EndoS, Specialist in Endodontics; EndoR, Resident in Endodontics. (Significance codes used are: *** for 0.001, * for 0.05, Slopes are designated with corresponding number of stripes).</p> Full article ">Figure 5
<p>Categorization of dentists willing to perform endodontic treatment in patients at risk of infective endocarditis. (<b>A</b>) Effect of sex and years of practice of dental practitioners on antibiotic prescription; (<b>B</b>) effect of continuing dental education on endodontics taken by dental practitioners in the last 5 years (CE) on antibiotic prescription; (<b>C</b>) effect of educational qualifications of the dental practitioner on antibiotic prescription; (<b>D</b>) effect of office organization on antibiotic prescription; (<b>E</b>) effect of office type on antibiotic prescription; (<b>F</b>) effect of rubber dam use on antibiotic prescription; (<b>G</b>) effect of “single-visit endodontic treatment” on antibiotic prescription. HC, health center; Conc, dental clinic with concession contract; Priv, private clinic; PrivSA, private clinic with a health fund contract; Poly, dental polyclinic; SDM, school of dental medicine; DDM, Doctor of Dental Medicine without specialization; EndoS, Specialist in Endodontics; EndoR, Resident in Endodontics. (Significance codes used are: *** for 0.001, ** for 0.01, * for 0.05, dot for 0.1. Slopes are designated with corresponding number of stripes whereas a dotted stripe corresponds to a dot, i.e., to 0.1 significance).</p> Full article ">
9 pages, 211 KiB  
Article
Antibiotic-Prescribing Habits in Dentistry: A Questionnaire-Based Study
by Luca Sbricoli, Giulio Grisolia, Edoardo Stellini, Christian Bacci, Marco Annunziata and Eriberto Bressan
Antibiotics 2024, 13(2), 189; https://doi.org/10.3390/antibiotics13020189 - 16 Feb 2024
Cited by 1 | Viewed by 1527
Abstract
The problem of antibiotic resistance is becoming increasingly serious worldwide due to uncontrolled prescription. Dentists are among the groups that prescribe the most antibiotics, often to delay urgent treatment. The purpose of the present study is to investigate the prescribing protocols adopted by [...] Read more.
The problem of antibiotic resistance is becoming increasingly serious worldwide due to uncontrolled prescription. Dentists are among the groups that prescribe the most antibiotics, often to delay urgent treatment. The purpose of the present study is to investigate the prescribing protocols adopted by dentists for prophylaxis and antibiotic therapy in major clinical surgical indications. Methods: A ten-question survey was administered to a group of Italian dentists. The participants were asked about their preferences for antibiotic administration for the prevention of infective endocarditis, the administration of antibiotics to patients allergic to penicillin, the insertion of implants, and the extraction of third molars. The retrieved data were screened and analyzed. Results: A total of 298 surveys were filled out. The most-prescribed antibiotic was amoxicillin or amoxicillin with clavulanic acid or macrolides for allergic patients. The administration of two grams of amoxicillin one hour before surgery was the most widely used prescriptive protocol for prophylaxis. International guidelines on antibiotic prophylaxis for infective endocarditis were only partially followed. The most heterogeneous results emerged for prophylaxis associated with dental implants or provided prior to surgical third-molar extraction. Conclusions: The present study shows widespread antibiotic prescriptive heterogeneity among the sample of dentists analyzed, especially in conditions where international guidelines are lacking. An evidence-based consensus on prescriptive modalities in dentistry would be desirable in the near future. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
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