Abstract
ObjectiveThe indiscriminate prescription of antibiotics has led to the emergence of resistance microbes worldwide. This study aimed to investigate the antibiotic prescribing practices amongst general dental practitioners and specialists in managing endodontic infections in the United Arab Emirates (UAE).DesignGeneral dental practitioners and specialists in the UAE were invited to participate in an online questionnaire survey which included questions on socio-demographics, practitioner’s antibiotic prescribing preferences for various pulpal and periapical diseases, and their choice, in terms of the type, dose and duration of the antibiotic. The link to the survey questionnaire was sent to 250 invited dentists. Data were analyzed by descriptive statistics and chi-square tests for independence and level of significance was set at 0.05.ResultsA total of 174 respondents participated in the survey (response rate = 70%). The respondents who prescribed antibiotics at least once a month were 38.5% while 17.2% did so, more than three times a week; amoxicillin 500 mg was the antibiotic of choice for patients not allergic to penicillin (43.7%), and in cases of penicillin allergies, erythromycin 500 mg (21.3%). There was a significant difference in the antibiotic prescribing practices of GDPs compared to endodontists and other specialties especially in clinical cases such as acute apical abscesses with swelling and moderate to severe pre-operative symptoms and retreatment of endodontic cases (p<0.05). Approximately, three quarters of the respondents (78.7%) did not prescribe a loading dose when prescribing antibiotics. About 15% respondents prescribed antibiotics to their patients if they were not accessible to patients due to a holiday/weekend.ConclusionsIn general, the antibiotic prescribing practices of UAE dentists are congruent with the international norms. However, there were occasions of inappropriate prescriptions such as in patients with irreversible pulpitis, necrotic pulps with no systemic involvement and/or with sinus tracts.
Highlights
Pulpal inflammations and pain associated with root canal infections generally require an operative intervention for relief of symptoms and not necessarily the prescription of systemic antibiotics [1, 2]
A total of 174 respondents participated in the survey
The respondents who prescribed antibiotics at least once a month were 38.5% while 17.2% did so, more than three times a week; amoxicillin 500 mg was the antibiotic of choice for patients not allergic to penicillin (43.7%), and in cases of penicillin allergies, erythromycin 500 mg (21.3%)
Summary
Pulpal inflammations and pain associated with root canal infections generally require an operative intervention for relief of symptoms and not necessarily the prescription of systemic antibiotics [1, 2]. The mandatory use of an antibiotic in general is limited to infections associated with fever, and evidence of systemic spread such as lymphadenopathy and trismus [1]. The American Association of Endodontists (AAE) for instance, recommends antibiotic prescription in medically healthy patients when diffuse swelling is present due to an apical abscess, or in an infection with systemic symptoms such as fever and malaise [1]. The European Society of Endodontology (ESE) recommends systemic adjunctive antibiotic therapy in acute apical abscess with associated fever, malaise, lymphadenopathy, trismus and progressive infections such as cellulitis or osteomyelitis [2]. Studies have shown significant variations amongst antibiotic prescribing habits amongst clinicians in terms of the dose and duration for almost identical infections [5,6,7]
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