Keywords
Students, dental
Endodontics
Iraq
How to Cite
Abstract
Aim: This study aimed to examine the prescription of antibiotics for endodontic infections among undergraduate dental students. Methods: Two government Iraqi dental schools [(the University of Baghdad (UOB) (n=99) and University of Babylon (UB) (n=70)], and one private dental school [Osouldeen University College (OUC) (n=103)] were included in this survey study. A paper-based questionnaire composed of seven questions was distributed to students, and collected. A chi-square test was used for data analysis, and the level of significance was set at 0.05 (P=0.05). Results: A statistically significant difference (P<0.05) was identified between students’ answers in the three dental schools regarding antibiotic selection for endodontic infections in which patients had no known allergies (P=0.001). In comparison to other dental schools, a statistically significantly higher proportion of respondents from UOB (32%) favored Azithromycin 500mg for treating patients with penicillin hypersensitivity (P=0.003). A high percentage of participants (62.1%) selected antibiotic prescription in cases with necrotic pulp and symptomatic apical periodontitis (with swelling and moderate/severe preoperative symptoms). However, there were no significant differences between the 3 dental schools (P>0.05). Conclusion: In conclusion, a significantly greater percentage of UB chose amoxicillin for the treatment of endodontic infection in patients with no medical allergies. Azithromycin 500mg was selected by UOB as the preferred option in patients who were sensitive to penicillin. Our findings support the need for the implementation of strategies to raise awareness of good antibiotic prescribing practices among dentists in Iraq.
References
World Health Organization. The evolving threat of antimicrobial resistance: options for action. WHO Published; 2014 [cited 2022 Mar 10]. Available from: https://apps.who.int/iris/handle/10665/44812.
Salvadori M, Audino E, Venturi G, Garo ML, Salgarello S. Antibiotic prescribing for endodontic infections: a survey of dental students in Italy. Int Endod J. 2019 Sep;52(9):1388-96. doi: 10.1111/iej.13126.
Siqueira JF, Rôças IN, Silva MG. Prevalence and clonal analysis of porphyromonas gingivalis in primary endodontic infections. J Endod. 2008 Nov;34(11):1332-6. doi: 10.1016/j.joen.2008.08.021.
Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, et al. Antibiotics in Endodontics: a review. Int Endod J. 2017 Dec;50(12):1169-84. doi: 10.1111/iej.12741.
Epstein JB, Chong S, Le D. A survey of antibiotic use in dentistry. J Am Dent Assoc. 2000 Nov;131(11):1600-9. doi: 10.14219/jada.archive.2000.0090.
AAE Position Statement: AAE Guidance on the Use of Systemic Antibiotics in Endodontics. J Endod. 2017 Sep;43(9):1409-13. doi: 10.1016/j.joen.2017.08.015.
Segura-Egea JJ, Martín-González J, Jiménez-Sánchez M del C, Crespo-Gallardo I, Saúco-Márquez JJ, Velasco-Ortega E. Worldwide pattern of antibiotic prescription in endodontic infections. Int Dent J. 2017 Aug;67(4):197-205. doi: 10.1111/idj.12287.
Ajantha GS, Hegde V. Antibacterial drug resistance and its impact on dentistry. N Y State Dent J. 2012 Jun-Jul;78(4):38-41.
Dutta A, Smith-Jack F, Saunders WP. Prevalence of periradicular periodontitis in a Scottish subpopulation found on CBCT images. Int Endod J. 2014 Sep;47(9):854-63. doi: 10.1111/iej.12228.
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. doi: 10.1111/j.1365-2591.2010.01691.x.
Whitten BH, Gardiner DL, Jeansonne BG, Lemon RR. Current trends in endodontic treatment: report of a national survey. J Am Dent Assoc. 1996 Sep;127(9):1333-41. doi: 10.14219/jada.archive.1996.0444.
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 May;28(5):396-404. doi: 10.1097/00004770-200205000-00012.
Perić M, Perković I, Romić M, Simeon P, Matijević J, Mehičić GP, et al. The Pattern of Antibiotic Prescribing by Dental Practitioners in Zagreb, Croatia. Cent Eur J Public Health. 2015 Jun;23(2):107-13. doi: 10.21101/cejph.a3981.
Bansal R, Jain A, Goyal M, Singh T, Sood H, Malviya HS. Antibiotic abuse during endodontic treatment: acontributing factor to antibiotic resistance. J Fam Med Prim Care. 2019 Nov;8(11):3518-24. doi: 10.4103/jfmpc.jfmpc_768_19.
Licata F, Di Gennaro G, Cautela V, Nobile CGA, Bianco A. Endodontic infections and the extent of antibiotic overprescription among Italian dental practitioners. Antimicrob Agents Chemother. 2021 Sep;65(10):e0091421. doi: 10.1128/AAC.00914-21.
B. Abraham S, Abdulla N, Himratul-Aznita WH, Awad M, Samaranayake LP, Ahmed HMA. Antibiotic prescribing practices of dentists for endodontic infections; a cross-sectional study. PLoS One. 2020 Dec;15(12):e0244585. doi: 10.1371/journal.pone.0244585.
Scaioli G, Gualano MR, Gili R, Masucci S, Bert F, Siliquini R. Antibiotic use: a cross-sectional survey assessing the knowledge, attitudes and practices amongst students of a school of medicine in Italy. PLoS One. 2015 Apr;10(4):e0122476. doi: 10.1371/journal.pone.0122476.
Jain A, Gupta D, Singh D, Garg Y, Saxena A, Chaudhary H, et al. Knowledge regarding prescription of drugs among dental students: A descriptive study. J Basic Clin Pharm. 2015 Dec;7(1):12-6. doi: 10.4103/0976-0105.170584.
Rodriguez-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 Sep;35(9):1198-203. doi: 10.1016/j.joen.2009.05.031.
Guzmán-Álvarez R, Medeiros M, Reyes Lagunes LI, Campos-Sepúlveda AE. Knowledge of drug prescription in dentistry students. Drug Healthc Patient Saf. 2012;4:55-9. doi: 10.2147/DHPS.S30984.
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 Jan;51(1):118-27. doi: 10.1111/iej.12778.
Bolfoni MR, Pappen FG, Pereira-Cenci T, Jacinto RC. Antibiotic prescription for endodontic infections: a survey of Brazilian Endodontists. Int Endod J. 2018 Feb;51(2):148-56. doi: 10.1111/iej.12823.
Stein GE, Schooley S, Tyrrell KL, Citron DM, Goldstein EJC. Human serum activity of telithromycin, azithromycin and amoxicillin/clavulanate against common aerobic and anaerobic respiratory pathogens. Int J Antimicrob Agents. 2007 Jan;29(1):39-43. doi: 10.1016/j.ijantimicag.2006.08.041.
Baumgartner JC, Xia T. Antibiotic susceptibility of bacteria associated with endodontic abscesses. J Endod. 2003 Jan;29(1):44-7. doi: 10.1097/00004770-200301000-00012.
Kuriyama T, Williams DW, Yanagisawa M, Iwahara K, Shimizu C, Nakagawa K, et al. Antimicrobial susceptibility of 800 anaerobic isolates from patients with dentoalveolar infection to 13 oral antibiotics. Oral Microbiol Immunol. 2007 Aug;22(4):285-8. doi: 10.1111/j.1399-302X.2007.00365.x.
Australian Medicines Handbook 2017. Australian Medicines Handbook; 2017.
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. Published online 2018 Jan;51(1):20-25. doi: 10.1111/iej.12781.
Agnihotry A, Fedorowicz Z, van Zuuren EJ, Farman AG, Al-Langawi JH. Antibiotic use for irreversible pulpitis. Cochrane Database Syst Rev. 2016 Feb;2:CD004969. doi: 10.1002/14651858.CD004969.pub4.
Skučaitė N, Pečiulienė V, Manelienė R, Mačiulskienė V. Antibiotic prescription for the treatment of endodontic pathology: a survey among Lithuanian dentists. Medicina. 2010;46(12):806. doi: 10.3390/medicina46120113.
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. doi: 10.1111/j.1365-2591.2009.01642.x.
Pallasch TJ. How to use antibiotics effectively. J Calif Dent Assoc. 1993 Feb;21(2):46-50.
Nabavizadeh MR, Sahebi S, Nadian I. Antibiotic prescription for endodontic treatment: General dentist knowledge + practice in Shiraz. Iran Endod J. 2011 Spring;6(2):54-9. doi: 10.22037/iej.v6i2.2091.
Nagle D, Reader A, Beck M, Weaver J. Effect of systemic penicillin on pain in untreated irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Nov;90(5):636-40. doi: 10.1067/moe.2000.109777.
Montagner F, Jacinto RC, Correa Signoretti FG, Scheffer de Mattos V, Grecca FS, Gomes BP. Beta-lactamic resistance profiles in Porphyromonas, Prevotella, and Parvimonas species isolated from acute endodontic infections. J Endod. 2014 Mar;40(3):339-44. doi: 10.1016/j.joen.2013.10.037.
Pulcini C, Gyssens IC. How to educate prescribers in antimicrobial stewardship practices. Virulence. 2013 Feb;4(2):192-202. doi: 10.4161/viru.23706.
Lee CR, Lee JH, Kang LW, Jeong BC, Lee SH. Educational effectiveness, target, and content for prudent antibiotic use. Biomed Res Int. 2015;2015:214021. doi: 10.1155/2015/214021.
Stevens NT, Bruen C, Boland F, Pawlikowska T, Fitzpatrick F, Humphreys H. Is online case-based learning effective in helping undergraduate medical students choose the appropriate antibiotics to treat important infections? 2019 Dec;1(3):dlz081. doi: 10.1093/jacamr/dlz081.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Mazen M Jamil Al-Obaidi, Elaf Ahmed Hadi, Zeyad Nazar al-Talib, Aqil M Daher, Mohammed Al-Adhamy, Hany Mohamed Aly Ahmed
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