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Objectives: After the shutdown of most dental services during the COVID‐19 lockdown, the oral health community was concerned about an increase in prescribing opioids and antibiotics by dentists due to patients' limited access to dental offices. Therefore, the objective of this study was to investigate the impact of COVID‐19 pandemic on the pattern of antibiotic and opioid prescriptions by dentists in Alberta, Canada. Methods: Data obtained from the Tracked Prescription Program were divided into antibiotics and opioids. Time periods were outlined as pre‐, during‐, and postlockdown (phase 1 and 2). For the number of prescriptions and average supply, each monthly average was compared to the corresponding prelockdown monthly average, using descriptive analysis. Time series analyses were conducted using regression analyses with an autoregressive error model. Data were trained and tested on monthly observations before lockdown and predicted for during‐ and postlockdown. Results: A total of 1.1 million antibiotics and 400,000 opioids dispense were tracked. Decreases in the number of prescriptions during lockdown presented for antibiotics (n = 24,933 vs. 18,884) and opioids (n = 8892 vs. 6051). Average supplies (days) for the antibiotics (n = 7.10 vs. 7.55) and opioids (n = 3.92 vs. 4.05) were higher during the lockdown period. In the trend analyses, the monthly number of antibiotic and opioid prescriptions showed the same pattern and decreased during lockdown. Conclusion: The COVID‐19 pandemic altered the trends of prescribing antibiotics and opioids by dentists. The full impact of COVID‐19 pandemic on the population's oral health in light of changes in prescribing practices by dentists during and after lockdown warrants further investigation. [ABSTRACT FROM AUTHOR]

Objective: To identify the frequency and types of prescription errors, assess adherence to WHO prescribing indicators, and highlight the gaps in current prescribing practices of Junior dental practitioners in a tertiary care hospital in Karachi, Pakistan. Methods: This cross-sectional study was conducted from January 2021 to March 2021. The study included the prescriptions by house surgeons and junior postgraduate medical trainees for walk-in patients visiting the dental outpatient department. A total of 466 prescriptions were evaluated for WHO core drug prescribing indicators. The prescription error parameters were prepared by studying the WHO practical manual on guide to good prescribing and previous studies. Prescription errors, including errors of omission related to the physician and the patients, along with errors of omission related to the drug, were also noted. The statistical analysis was performed with SPSS version 25. Descriptive analysis was performed for qualitative variables in the study. Results: The average number of drugs per encounter was found to be 3.378 drugs per prescription. The percentage of encounters with antibiotics was 96.99%. Strikingly, only 16.95% of the drugs were prescribed by generic names and 23.55% of drugs belonged to the essential drug list. The majority lacked valuable information related to the prescriber, patient, and drugs. Such as contact details 419 (89.9%), date 261 (56%), medical license number 466 (100%), diagnosis 409 (87.8%), age and address of patient 453 (97.2%), form and route of drug 14 (3%), missing drug strength 69 (14.8%), missing frequency 126 (27%) and duration of treatment 72 (15.4%). Moreover, the wrong drug dosage was prescribed by 89 (19%) prescribers followed by the wrong drug in 52 (11.1%), wrong strength in 43 (9.2%) and wrong form in 9 (1.9%). Out of 1575 medicines prescribed in 466 prescriptions, 426 (27.04%) drug interactions were found and 299 (64%) had illegible handwriting. Conclusion: The study revealed that the prescription writing practices among junior dental practitioners are below optimum standards. The average number of drugs per encounter was high, with a significant percentage of encounters involving antibiotics. However, a low percentage of drugs were prescribed by generic name and from the essential drug list. Numerous prescription errors, both omissions and commissions, were identified, highlighting the need for improved training and adherence to WHO guidelines on good prescribing practices. Implementing targeted educational programs and stricter regulatory measures could enhance the quality of prescriptions and overall patient safety. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of odontogenic infections remains one of the highest in the world. If untreated, odontogenic infections can break through the limitation, disseminate to other organs or spaces, and cause high mortality rates. However, it is still difficult to rapidly target limited or disseminated infections in clinical practice. The type of disseminated odontogenic infections and the responsible bacteria have not been described in detail. Methods: Search databases (e.g., PubMed, MEDLINE, Web of Science, Embase) for reports published from 2018.1 to 2022.9. Use search strategies: ("odontogenic infections" OR "pulpitis" OR "periapical lesions" OR "periodontal diseases") AND ("disseminated infections" OR "complication"). Results: Fourteen different types of disseminated odontogenic infections, most of which are polymicrobial infections, can spread through the body either direct or through hematogenous diffusion. Multiple microbial infections can be more invasive in the transmission of infection. Secondary infections are commonly associated with bacteria like Fusobacterium spp., Streptococcus spp., Peptostreptococcus spp., Prevotella spp., and Staphylococcus spp. Antibiotics with broad-spectrum activity are fundamental as first-line antimicrobial agents based on the microorganisms isolated from disseminated infections. Conclusion: This review elaborates on the epidemiology, microorganisms, risk factors, and dissemination routes, and provides evidence-based opinions on the diagnosis, multidisciplinary management, and prevention of odontogenic infections for dentists and clinicians. [ABSTRACT FROM AUTHOR]

Purpose: Antibiotic resistance is one of the biggest threats to global health today. The aim of this study was to analyze antibiotic prescribing patterns and quality of prescribing in Croatian dental practices over a 5-year period. Methods: This is a retrospective observational study based on the analysis of the electronic prescriptions (medicines in ATC groups J01 and P01) from dental practices in Croatia prescribed from 1 January 2015 to 31 December 2019. Prescriptions were retrieved from the Croatian Health Insurance Fund (HZZO). The analyses included the number of prescriptions, type and quantity of prescribed drugs, indication, and the patient's and prescriber's characteristics. Results: The consumption increased from 1.98 DID in 2015, to 2.10 DID in 2019. The most prescribed antibiotic was Amoxicillin with clavulanic acid followed by Amoxicillin, Clindamycin, Metronidazole and Cefalexin. The analyses showed that 29.79% of antibiotics were not prescribed in accordance with the contemporary guidelines for the proper use of antibiotics. Additionally, 22% of antibiotics were prescribed in inconclusive indications. Conclusion: The research showed an increase in antibiotic consumption over five years along with unnecessary prescribing of antibiotics in cases with no indications for its use. The development of national guidelines for antibiotic use is necessary. [ABSTRACT FROM AUTHOR]

After pulp infection and necrosis, the passage of microbial antigens into the periapical space causes apical periodontitis (AP). Most of the clinical forms of AP can be managed without prescribing antibiotics, only with root canal treatment and abscess drainage or, where appropriate, tooth extraction. However, the scientific literature provides evidence of inappropriate antibiotic prescriptions by dentists in the management of apical disease. Objectives: The aim of this systematic review and meta-analysis was to analyze the global pattern of antibiotic prescription in the treatment of apical disease. Methods: PRISMA Guidelines were followed to carry out this systematic review. The research question was as follows: What is the pattern of antibiotic prescription by dentists in the treatment of the different clinical forms of apical periodontitis? A systematic search was conducted on MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. All studies reporting data about the pattern of antibiotic prescription by dentists in the treatment of apical disease were included. The meta-analyses were calculated using the Open Meta Analyst version 10.10 software. Random-effects meta-analyses were performed. The risk of bias was assessed using the Newcastle–Ottawa Scale. The certainty of evidence was assessed using GRADE. Results: The search strategy identified 96 articles and thirty-nine cross-sectional studies fulfilled the inclusion criteria. The overall percentage of antibiotic prescriptions by dentists in cases of symptomatic AP was 25.8%, and 31.5% in cases of asymptomatic AP with sinus tract present. The percentage of dentists prescribing antibiotics in cases of acute apical abscess with no/mild symptoms was 47.7%, whereas, in cases of acute apical abscess with moderate/severe symptoms, 88.8% of dentists would prescribe antibiotics. Endodontists prescribe antibiotics at a lower rate than general practitioners. The total risk of bias was considered moderate, and the final rating for the certainty of the evidence was low. Conclusions: Dentists worldwide are over-prescribing antibiotics in the management of apical disease. It is necessary to improve antibiotic prescribing habits in the treatment of endodontic infections, as well as educational initiatives to encourage the rational and appropriate prescription of antibiotics in periapical diseases. [ABSTRACT FROM AUTHOR]

The article shares insight on the role of dental practitioners in salivary gland health and in the management of related disorders. Emphasis is given on the need for dental practitioners to assess salivary gland function during routine exams and to diagnose various salivary gland disorders. It suggests an interdisciplinary approach to the management of systemic disorders like Sjögren syndrome. Also noted is the role of dental practitioners in identifying salivary gland tumors.

IntroductionThe misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have emphasized the need to reduce and limit the precipitation. In this study we aimed to identify the prevalence, type, dose, and duration of antibiotics prescribed by general medical and dental practitioners in Saudi Arabia. Materials and MethodsThis cross-sectional study was performed from April 2020 to December 2020. A total of 45,100 antibiotic prescriptions were collected from different governmental and private pharmacies and screened to be included in this study. Data extraction from all prescriptions followed a standardized form that included the following information: Doctor specialty, type of antibiotic, duration, and dose of antibiotic. ResultsA total of 38,175 antibiotic prescriptions prescribed by licensed doctors practicing in governmental or private hospitals were included in this study. Thirty-five thousand one hundred and seventy-eight (92%) outpatient antibiotics were prescribed by medical practitioners, and 2997 (8%) antibiotics were prescribed by dentists. The most commonly prescribed antibiotic was Augmentin (60%), followed by metronidazole and amoxicillin (35%). The most common dose and duration prescribed by dentists for Augmentin was 625 mg, 3 times per day for 5 days, whereas that of metronidazole was 500 mg, 3 times per day for 7 days. Prescribed dose and duration of amoxicillin was 500 mg, 3 times per day for 7 days. ConclusionsThis study helps in understanding healthcare practitioners’ patterns and adds to the knowledge on how to deal with odontogenic infections. Further national studies are recommended to include more regions in Saudi Arabia and to illustrate the misuse of outpatient antibiotics.

Introduction: To determine the pattern of antibiotic prescription and to assess the knowledge of antibiotic resistance among dentists. Material and Methods: An electronic version of the questionnaire regarding antibiotic use and knowledge on antibiotic resistance was created using google forms and a link was mailed to dental surgeons and their response was recorded. Data obtained was recorded and analysed using descriptive statistics. Results: Out of 130 responses recorded 45.4% of dentists prefer prescribing antibiotics daily. Amoxicillin was the most often recommended antibiotic by majority (49.6%) of the practitioners, While 54.6% of dentists considered a duration of 3 days course of antibiotics for odontogenic infections. 43.7% of the respondent's considered clindamycin as an alternative in penicillin-allergic patients. Abscess was the most common (67.2%) condition considered for antibiotic prescription, 49.6% of the participants stated that availability of a particular brand as a primary factor for prescription of antibiotics. 40.3% of dental surgeons felt that failure to prescribe antibiotics was the main reason for the spread of infection. Almost 91.8% of dental surgeons were aware that antibiotic resistance was becoming a global concern. Conclusion: Antibiotics revolutionized the way infections are being treated, Although incorrect and inappropriate use of antibiotics could be a contributing factor for the development of Antibiotic Resistance. Anti-microbial stewardship should be deeply integrated into dental practice and oral health care, to reduce the number of unnecessary prescriptions and educational intervention is utmost essential to limit non-medical prescriptions. [ABSTRACT FROM AUTHOR]

Introduction: The misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have emphasized the need to reduce and limit the precipitation. In this study we aimed to identify the prevalence, type, dose, and duration of antibiotics prescribed by general medical and dental practitioners in Saudi Arabia. Materials and Methods: This cross-sectional study was performed from April 2020 to December 2020. A total of 45,100 antibiotic prescriptions were collected from different governmental and private pharmacies and screened to be included in this study. Data extraction from all prescriptions followed a standardized form that included the following information: Doctor specialty, type of antibiotic, duration, and dose of antibiotic. Results: A total of 38,175 antibiotic prescriptions prescribed by licensed doctors practicing in governmental or private hospitals were included in this study. Thirty-five thousand one hundred and seventy-eight (92%) outpatient antibiotics were prescribed by medical practitioners, and 2997 (8%) antibiotics were prescribed by dentists. The most commonly prescribed antibiotic was Augmentin (60%), followed by metronidazole and amoxicillin (35%). The most common dose and duration prescribed by dentists for Augmentin was 625 mg, 3 times per day for 5 days, whereas that of metronidazole was 500 mg, 3 times per day for 7 days. Prescribed dose and duration of amoxicillin was 500 mg, 3 times per day for 7 days. Conclusions: This study helps in understanding healthcare practitioners' patterns and adds to the knowledge on how to deal with odontogenic infections. Further national studies are recommended to include more regions in Saudi Arabia and to illustrate the misuse of outpatient antibiotics. [ABSTRACT FROM AUTHOR]

Abstract Background No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings. Methods This was a retrospective study of veteran and non-veteran dental patients with cardiac conditions or prosthetic joints between 2015–2017. Multivariable log binomial regression analysis was conducted to compare concordant prescribing by setting with a sub-analysis for errors of dosing based on antibiotic duration (i.e., days prescribed). Results A total of 61,124 dental visits that received a prophylactic antibiotic were included. Most were male (61.0%), and 55 years of age or older (76.2%). Nearly a third (32.7%) received guideline concordant prophylaxis. VA dental settings had a lower prevalence of guideline concordant prescribing compared to non-VA settings in unadjusted results (unadjusted prevalence ratio [uPR] = 0.92, 95% CI: 0.90–0.95). After adjustment, prevalence of guideline concordant prescribing was higher in those with prosthetic joints in the VA setting (adjusted prevalence ratio [aPR] = 1.73, 95% CI: 1.59–1.88), with no difference identified in those without a prosthetic joint (aPR = 0.99, 95% CI: 0.96–1.01). Concordance of dosing was higher in VA compared to non-VA settings (aPR = 1.11, 95% CI: 1.07–1.15). Conclusions VA has a higher prevalence of guideline concordant prescribing among those with prosthetic joints and when assessing dosing errors. Though the presence of an integrated electronic health record (EHR) may be contributing to these differences, other system or prescriber-related factors may be responsible. Future studies should focus on to what extent the integrated EHR may be responsible for increased guideline concordant prescribing in the VA setting.

Background: The prescription of antibiotics in dental practice contributes significantly to the total use of antibiotics in primary healthcare. This study aimed to evaluate antibiotic prescription in dental practice during the years 2016–2021 in Norway and their relative contribution to national outpatient consumption and to investigate the influence of age, gender, geographic region, and COVID-19. A further aim was to review differences in prescribing patterns to verify effect of governmental strategies to reduce over-prescribing of antibiotics. Methods: This register study investigated the national antibiotic prescription between 2016 and 2021. Data was obtained from the Norwegian prescription register, the Norwegian Institute of Public Health and Statistics Norway. The consumption of 12 common antibiotics was measured using WHO defined daily doses (DDDs), DDD per 1000 inhabitants per day (DIDs 1000). Results: A total of 6,049,445 antibiotic prescriptions of the 12 investigated compounds were issued in primary care during the study period. Dentists accounted for 942,350 prescriptions corresponding to 15.6% of the total. An overall decrease in the number of prescriptions by health professions other than dentists during the 5 years (IRR = 0.92, 95% CI:0.92–0.93, p < 0.001) was observed. For dentists a slight increase in the number of prescriptions (IRR = 1.01, 95% CI: 1.01–1.01, p < 0.001) was seen over the study period. The increase of antibiotic prescriptions in dentistry was more pronounced during the COVID-19 pandemic. The 4 most prescribed type of antibiotics based on average number of DDDs of the total period 2016–2021 were in descending order; phenoxymethylpenicillin (1,109,150) followed by amoxicillin (126,244), clindamycin (72,565), and metronidazole (64,599). An unexpected finding was that the prescription of the combination compound amoxicillin/clavulanic acid had significantly increased in dentistry during the last 5 years. Geographic, gender, and age differences in the rates of prescriptions were also seen. The data revealed that there are seasonal variations in dental prescriptions. Conclusions: Noticeable differences exist in prescribing patterns of antibiotics in the last 5 years. Restricted access to dental care due to COVID-19 may have resulted in increased antibiotic prescribing in dentistry as opposed to an otherwise downward trend. Despite national guidelines there is still a need for improvement of antibiotic stewardship in dentistry and to define effective methods to disseminate information. [ABSTRACT FROM AUTHOR]

Introduction: Over the years, there has been an increase in the practice of self-medication (SM) with over-the-counter drugs for dental conditions. Regarding paediatric patients, it is important for parents to have proper knowledge, attitude, and practice (KAP) regarding SM for their children. Aim: To assess the parental KAP towards SM for various oral health-related problems of children below 15 years of age. Materials and Methods: A cross-sectional study was conducted at schools in Nellore, Andhra Pradesh, India, between March 2021 and January 2022. A total of 323 parents of children aged up to 15 years were included in the study. Data were collected from parents through a prevalidated questionnaire to record their demographic details and KAP of SM. Fisher's exact test was used to compare KAP of SM with the age, gender, education, and socioeconomic status (SES) of parents. Results: The most common medicine and reason for which SM was practiced were pain relievers (85%) and expensive dental treatment (39.8%), respectively. The pharmacist was the most common source of information for SM (46.9%) and drug dosage (46%). There was a significant association (p=<0.001) between children age groups and the presentation form of medicine. Additionally, statistically significant differences were found when comparing parents' educational level and SES with dosage difference (p=0.01, p=<0.001), route of administration of medicine (p=0.04, p=<0.002), preference for expensive medicine (p=<0.001, p=<0.001), and reasons for not visiting the dentist (p=<0.01, p=<0.001), respectively. Furthermore, when SES was compared with course completion, a statistically significant difference was found (p=<0.05). Conclusion: Knowledge regarding SM practice was lower in the low educational and low SES groups. [ABSTRACT FROM AUTHOR]

Background: Molar incisor hypomineralization (MIH) is a global dental condition. Early intake of antibiotics can increase the risk of MIH. Purpose: To assess the knowledge of physicians and dentists on MIH and its associations with antibiotics exposure during early childhood. Methods: This cross-sectional study surveyed the above health professionals utilizing an electronically distributed questionnaire. The chi-square test was used to compare differences in levels of knowledge between the study groups. Results: There were 335 participants in the study; general physicians (n=79), pediatricians (n=98) and dentists (n=158). A significantly lower proportion of general physicians and pediatricians had knowledge of MIH compared to dentists (19% and 18% vs. 82%, respectively, P

Purpose: Antibiotic resistance is one of the biggest threats to global health today. The aim of this study was to analyze antibiotic prescribing patterns and quality of prescribing in Croatian dental practices over a 5-year period. Methods: This is a retrospective observational study based on the analysis of the electronic prescriptions (medicines in ATC groups J01 and P01) from dental practices in Croatia prescribed from 1 January 2015 to 31 December 2019. Prescriptions were retrieved from the Croatian Health Insurance Fund (HZZO). The analyses included the number of prescriptions, type and quantity of prescribed drugs, indication, and the patient’s and prescriber’s characteristics. Results: The consumption increased from 1.98 DID in 2015, to 2.10 DID in 2019. The most prescribed antibiotic was Amoxicillin with clavulanic acid followed by Amoxicillin, Clindamycin, Metronidazole and Cefalexin. The analyses showed that 29.79% of antibiotics were not prescribed in accordance with the contemporary guidelines for the proper use of antibiotics. Additionally, 22% of antibiotics were prescribed in inconclusive indications. Conclusion: The research showed an increase in antibiotic consumption over five years along with unnecessary prescribing of antibiotics in cases with no indications for its use. The development of national guidelines for antibiotic use is necessary.

Introduction: There are limited paediatric specific data on antibiotic prescribing practices, which have been cited as one of the causes of general overuse and misuse of antibiotics in young patients. The aim of this study was to investigate prescribing practices among dentists with an interest in paediatric dentistry in the UK. Methods: A prospective cross-sectional survey was distributed electronically to members of the British Society of Paediatric Dentistry between February and May 2021. The questions and scenarios were based on antibiotic prescribing guidelines in the UK. Results: Two hundred and six dentists completed the survey (45% response rate). Most participants (93%) conformed to guidelines and prescribed amoxicillin as a first-line antibiotic for an odontogenic infection. For patients with a penicillin allergy, 16% of dentists reported clindamycin as their first-choice antibiotic. Seventeen per cent of those surveyed stated that they would prescribe antibiotics for local swelling without any additional factors indicating a persistent or spreading bacterial infection. Further insights into prescribing practices for prophylaxis, paediatric doses and non-clinical factors are described. Conclusions: Antibiotics are part of the armamentarium that dentists can use to treat patients. The results of this survey highlight some positive trends as well as some variation in prescribing practice that requires correction and discussion for future research. [ABSTRACT FROM AUTHOR]

Background: No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings. Methods: This was a retrospective study of veteran and non-veteran dental patients with cardiac conditions or prosthetic joints between 2015–2017. Multivariable log binomial regression analysis was conducted to compare concordant prescribing by setting with a sub-analysis for errors of dosing based on antibiotic duration (i.e., days prescribed). Results: A total of 61,124 dental visits that received a prophylactic antibiotic were included. Most were male (61.0%), and 55 years of age or older (76.2%). Nearly a third (32.7%) received guideline concordant prophylaxis. VA dental settings had a lower prevalence of guideline concordant prescribing compared to non-VA settings in unadjusted results (unadjusted prevalence ratio [uPR] = 0.92, 95% CI: 0.90–0.95). After adjustment, prevalence of guideline concordant prescribing was higher in those with prosthetic joints in the VA setting (adjusted prevalence ratio [aPR] = 1.73, 95% CI: 1.59–1.88), with no difference identified in those without a prosthetic joint (aPR = 0.99, 95% CI: 0.96–1.01). Concordance of dosing was higher in VA compared to non-VA settings (aPR = 1.11, 95% CI: 1.07–1.15). Conclusions: VA has a higher prevalence of guideline concordant prescribing among those with prosthetic joints and when assessing dosing errors. Though the presence of an integrated electronic health record (EHR) may be contributing to these differences, other system or prescriber-related factors may be responsible. Future studies should focus on to what extent the integrated EHR may be responsible for increased guideline concordant prescribing in the VA setting. [ABSTRACT FROM AUTHOR]

PURPOSE: This study was conducted to assess the Knowledge, Attitude, and Practice (KAP) of patients or their caregivers, and prescribers of antibiotics toward antimicrobial resistance in Bangladesh. METHOD: This was a mixed-method research study. Data were collected from pre-determined study areas using a sample survey of 583 respondents, 11 Focus Group Discussions (FGDs), 11 Key-Informant Interviews (KIIs), and 11 In-depth Interviews (IDIs). A scale of 11 points was used to measure attitudes. RESULTS: About 59% of the respondents (patients or carers) were between 1 to 20 years old. The difference of age of patients by sex was found statistically significant at .001 level (x2 = 39.82, def. = 8; Cramer's V = .49). About 25.7% of the respondent s visited an MBBS doctor and 8.1% visited a BDS dentist, and 66.2% went to traditional healers and the pharmacy. Men take more antibiotics for treatment purposes compared to their female counterparts. The difference between men and women, with regard to the treatment of common diseases, was found to be statistically significant. (X2= 29.82; Cramer's V= .41, def. = 7; Sig; P= < .02). Usually, new graduate doctors and traditional healers prescribe antibiotics of longer durat ion. The duration of prescriptions for antibiotics and type of the physician was found statistically significant (x2= 19.22; Cramer's V= .28, def. = 8; Sig; P= < .02). Physicians prescribed common antibiotics for upper respiratory tract infections (26%), cold and fever (21%), diarrhea (12%), STDs (9%), HTN (8%), UTIs (7.5%), diabetes (5%), and lower respiratory infections (4%). Cephalosporin (31.4%), macrolides (27.6%), quinolones (17.8%), metronidazole (13%), and penicillin (10.10%) were used. About 65.8% of the caregivers did not have any knowledge about antimicrobial resistance and the negative effects of the overuse of antibiotics. CONCLUSION: The majority of the respondents had poor knowledge of antimicrobial resistance and the negative effects of the overuse of antibiotics. A community-based awareness program was found important to create awareness of antimicrobial resistance and the negative effects of the overuse of antibiotics. [ABSTRACT FROM AUTHOR]

Abstract Background The use of antibiotics in dental care is often unnecessary or inappropriate. Our objectives were to identify (i) Clusters of dentists grouped according to their appropriateness score based on proxy indicators’ results; and (ii) Dentists’ and patients’ characteristics associated with the appropriateness of antibiotic prescriptions. Methods We used data of the Health Insurance reimbursement databases on antibiotics prescribed in 2019 by general dental practitioners of the Grand Est region in France. The appropriateness of antibiotic prescriptions was estimated by the results of recently published proxy indicators. We conducted a cluster analysis according to an appropriateness score calculated for each dentist, using the Ward method. We then conducted bivariate and multivariable analyses to identify characteristics associated with these clusters. Results We included 3,014 dentists, who prescribed 373,975 antibiotics in 2019, and which were grouped into three clusters: average practices (n = 1,241), better (n = 686), and worse (n = 1,087) than average practices. Overall, dentists had more appropriate prescription practices when they were male (OR for belonging to cluster with “worse than average practices” = 1.37 (p = 0.003) for female), having a predominant surgery practice (p = 0.028) in the Lorraine area (p

Background and Objectives: Irrational use of antibiotics is one of the concerns in dentistry due to causing antimicrobial resistance and imposing cost burden on the patients. This study aims to evaluate the effect of educational intervention on prescription of antibiotics by general dentists in Qom, Iran. Methods: This study was conducted for three months on 134 general dentists in Qom province in two groups of intervention (n=67) and control (n=67). The intervention group participated in a seminar as a retraining course. Descriptive statistics including mean, standard deviation, percentage, and frequency were used to describe the data, and chi-square test was used to compare the two groups. Results: The data of 22418 prescriptions containing antibiotics were evaluated. The mean number of prescriptions in the intervention group before and after retraining was 62.73 and 72.92, respectively (P= 0.043), indicating a significant increase after retraining. The mean number of prescriptions in the control group before and after retraining was 96.88 and 100.06, respectively but there was no significant difference (P= 0.57). There was no significant difference in the number of prescriptions between the two groups after retraining (P=0.09). Conclusion: The educational intervention is relatively unsuccessful may be due to lack of motivation, lack of useful and effective teaching methods, and lack of participation in group discussions.

Background: There is scant knowledge of dentists' total prescribing patterns, and little is published on this internationally. The Norwegian Prescription Database (NorPD) includes data on all dispensed prescription medication in Norway from 2004 and can be used to investigate how dentists' prescribing has changed over time. There are few Norwegian guidelines supporting dentists' prescribing, and Norwegian legislation on dentists' prescribing rights leaves room for interpretation. The aim of this study was therefore to give an overview of all prescribing from dentists in Norway in the period 2005 to 2015 and to identify trends in their prescribing pattern over this time span. We also give characteristics of the prescribing dentists. Methods: The study had a retrospective pharmacoepidemiologic design. Data on all medication prescribed by dentists and dispensed from Norwegian pharmacies in the time period 2005 to 2015 were extracted from the NorPD. Changes over time in the prescribers, patients, and medications are reported. Results: There was an increase of 50% in total number of prescriptions from dentists in Norway from 2005 to 2015; adjusted for the growth in population, there was a 33% increase. The majority of prescriptions from dentists were for antibiotics and analgesics; however, the data reveal that the dentists prescribed from all major therapeutic groups. Dentists increased antibiotic prescribing in a period when total antibiotic prescribing in Norway decreased. Conclusions: Our study finds antibiotics and analgesics dominate prescriptions from Norwegian dentists and shows an increase in use over time. It highlights the need for creating evidence-based prescribing guidelines for dentists and for ensuring that existing guidelines are implemented.

Aim: The aim of this study was to describe the use patterns of antibiotics in periodontal therapy among Moroccan dentists. Materials and Methods: It was a cross-sectional study. An online survey among 2440 registered dentists was conducted in public, private, and semi-public sectors in Morocco. Within the interrogated dentists, 255 answer the online survey. Data analysis was done by the laboratory of biostatistics-epidemiology of the Faculty of Medicine of Casablanca. Results: The antibiotics were prescribed for different pathologies. 26.8% of dentists prescribed antibiotics for gingivitis, 91.5% in case of ulcero-necrotizing gingivitis, 92.7% for aggressive periodontitis, 77% to chronic periodontitis patients, and 97.6% in the presence of periodontal abscess. Dentists prescribed penicillin to 37.3% of cases presenting ulcero-necrotizing gingivitis and 62.3% of patients presenting periodontal abscess. Cyclins are prescribed at a rate of 60% to aggressive periodontitis patients. The association of penicillin + metronidazole is prescribed to 37.3% of ulcero-necrotizing gingivitis patients, 47% of patients presenting aggressive periodontitis, 42.5% of chronic periodontitis patients, and 65.5% of cases presenting periodontal abscess. Discussion: There are major discrepancies among dentists in antibiotic prescription patterns. Some dentists prescribe antibiotics to patients with gingivitis or patients undergoing noninvasive oral procedures such as air polishing and scaling which is worrisome. Dentists are prescribing antibiotics when local treatment would have sufficed. Dentists also commonly prescribed antibiotics as an adjunct to mechanical therapy for the treatment of periodontal disease. Conclusion: Systemic antibiotics are prescribed for different conditions according to variable protocols. The appropriateness of antibiotic prescription must be reassessed critically to improve antibiotic stewardship among dentists. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the perception of general dentists regarding the over-prescription of antibiotics leading to Antimicrobial drug resistance in their clinical practice. METHODOLOGY: A cross-sectional study encompassing a personalized Likert scale questionnaire on factors influencing anti-microbial resistance in dental general practices was conducted on 196 practitioners. The questionnaire inquired about different factors which tend to affect the over-prescription of antibiotics and influence anti-microbial resistance. It was piloted on 30 participants before dissemination. RESULTS: Factors showing the highest level of agreement were "lack of patient awareness regarding use of antibiotics" (96.9%), "over-the-counter availability" (95.4%), and self-medication" (95.4%). General dental practitioners were overprescribing in their clinical setup due to improper guidelines (24.4%), for their patient's satisfaction (21.2%), and lack of knowledge (19.2%). 33.5% of them stated that patients reporting to them were self-medicating and 27.2% found that their patients had a lack of awareness. CONCLUSIONS: This study concluded that all the factors were responsible for the Antimicrobial Drug Resistance phenomenon in clinical dental practice. However, the majority of the dentists were over-prescribing antibiotics due to improper guidelines, lack of knowledge, and for the patient's satisfaction. [ABSTRACT FROM AUTHOR]

Background: The use of antibiotics in dental care is often unnecessary or inappropriate. Our objectives were to identify (i) Clusters of dentists grouped according to their appropriateness score based on proxy indicators' results; and (ii) Dentists' and patients' characteristics associated with the appropriateness of antibiotic prescriptions. Methods: We used data of the Health Insurance reimbursement databases on antibiotics prescribed in 2019 by general dental practitioners of the Grand Est region in France. The appropriateness of antibiotic prescriptions was estimated by the results of recently published proxy indicators. We conducted a cluster analysis according to an appropriateness score calculated for each dentist, using the Ward method. We then conducted bivariate and multivariable analyses to identify characteristics associated with these clusters. Results: We included 3,014 dentists, who prescribed 373,975 antibiotics in 2019, and which were grouped into three clusters: average practices (n = 1,241), better (n = 686), and worse (n = 1,087) than average practices. Overall, dentists had more appropriate prescription practices when they were male (OR for belonging to cluster with "worse than average practices" = 1.37 (p = 0.003) for female), having a predominant surgery practice (p = 0.028) in the Lorraine area (p < 0.0001) for less years (p = 0.0002), when they had healthier patients (i.e., younger, with no chronic diseases, and who received less procedures), and when they had a more prudent use of drugs in general (i.e., less prescriptions of drugs, antibiotics, and non-steroidal anti-inflammatory). Conclusions: We identified clusters and characteristics associated with the appropriateness of antibiotic prescriptions made by dentists, which might help guiding antimicrobial stewardship interventions. [ABSTRACT FROM AUTHOR]

More than 50% of the use of antibiotics is considered inappropriate and dentists turn out to be part of the health professionals who misuse these drugs. Due to this, the objective of this study was to evaluate the prescription of antibiotics by Ecuadorian dentists after extraction of temporary teeth for systemic causes to determine the rational use of these drugs, among pediatric patients. This retrospective study used a survey of dentists in Ecuador as the primary database. The sample was obtained with the Epi Info application, with an expected frequency of 50%, a margin of error of 5% and a confidence level of 95%. Odd Ratio (OR) was used as a measure of association, obtained by logistic regression and Pearson's chi square to establish correlation. More than 11% of them mentioned having prescribed antibiotics after extracting a temporary tooth due to physiological causes. Those who most incurred this inappropriate use were male dentists, those under 30 years of age and those over 51 years of age, who work in urban areas and those who graduated from a public university and those who do not yet have a degree fourth level. The misuse or inappropriate use of antibiotics is a global problem in which many factors intervene, including the authorized prescribers of these drugs. Dentists are an important part of this problem and the factors identified in many studies are diverse. [ABSTRACT FROM AUTHOR]

Aim: Antibiotics are often prescribed for the treatment of various infections and prophylactic purposes in dental practice. Their improper use can cause microbial resistance to antibiotics, which poses a world-wide threat. The aim of this cross-sectional study was to evaluate the knowl edge and attitudes of dentists and dentistry students about antibiotic prescription practices for prophylaxis and the treatment of dental infections in pediatric patients. Methods: A questionnaire was e-mailed to 2,100 dentists and 300 senior dentistry students. The questionnaire was filled out by the participants within a 2-month period (May–June 2020). A 30-point scoring system was developed to assess the knowledge levels of the dentists according to the guidelines. Descriptive statistical analyses were performed. One-way ANOVA test and the Chi-Squared test were used to compare qualitative variables. Results: The response rate was found to be 24.2% for dentists and 49% for senior dentistry students. 19.4% of the participants were found to be moderately knowl edge able and 80.6% of them were highly knowledgeable. Students' knowledge scores were found to be higher than the general dentists and other specialists (p<0.05). There was no significant difference between students and pedodontists. Conclusion: Dentists were found to have sufficient knowledge about the usage of antibiotics in children, but there is still a lack of information about circumstances under which antibiotics should not be prescribed. Dentists and dentistry students should attend continuing education programs to keep their information up-to-date and should also prescribe antibiotics in adherence with the current guidelines to prevent antibiotic resistance. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and compare antibiotic prescriptions for endodontic infections of last-year undergraduate Dentistry students and dental surgeons from Brazil. Material and Methods: A questionnaire comprised of 15 questions was applied, including a series of hypothetical clinical cases through multiple choice questions. The survey respondents had the option to respond in favor or against the prescription of antimicrobials in each case. Afterwards, the commented answer keys of all topics contained in the survey form were released for educational purpose. Results: A total of 42 undergraduates and 115 dental surgeons answered the survey. Regarding the questions about antimicrobial prescriptions, 91.3% of the professional dentists and 69.8% of the dentistry students indicated that they prescribe antibiotics for a limited number of patients. However, when they responded about drug recommendations, most professionals (76.5%) and students (76.7%) chose to recommend antimicrobials without any clinical recommendation. Conclusion: In the groups herein evaluated, many antibiotic prescriptions could have been avoided. The rational use of these drugs is still a conduct that needs further disclosure and commitment among prescribers. [ABSTRACT FROM AUTHOR]

Background: Molar incisor hypomineralization (MIH) is a global dental condition. Early intake of antibiotics can increase the risk of MIH. Purpose: To assess the knowledge of physicians and dentists on MIH and its associations with antibiotics exposure during early childhood. Methods: This cross-sectional study surveyed the above health professionals utilizing an electronically distributed questionnaire. The chi-square test was used to compare differences in levels of knowledge between the study groups. Results: There were 335 participants in the study; general physicians («=79), pediatricians (n=98) and dentists («=158). A significantly lower proportion of general physicians and pediatricians had knowledge of MIH compared to dentists (19% and 18% vs. 82%, respectively, P<0.001). There was no statistically significant difference between all groups regarding their knowledge about the association between antibiotics prescribed during the first four years of life and MIH development (P=0.07). Conclusions: Physicians and pediatricians lacked knowledge about the dental condition of MIH. Most study respondents did not know the association between frequent antibiotic intake during early childhood and the development of MIH. Since medical practitioners are more likely to prescribe antibiotics and have a greater impact on early childhood health, raising awareness of MIH and its relationship with antibiotic exposure in early life among medical practitioners is essential. [ABSTRACT FROM AUTHOR]

Copyright of Universidade Estadual Paulista. Revista de Odontologia is the property of Universidade Estadual Paulista. Revista de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Odontologica Latinoamericana: AOL is the property of Acta Odontologica Latinoamericana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use. We conducted a systematic review of dentists' knowledge, attitudes and perceptions regarding antibiotic use, by searching the MEDLINE, EMBASE and Web of Science for all original paper published from January 1990 to July 2023, in accordance with the Preferred Reporting Items for systematic Reviews and Meta-analyses (PRISMA 2020) guidelines. The review included 37 papers, (7 qualitative and 30 quantitative studies). Modifiable factors (knowledge, attitudes) were reported as being associated with antibiotic prescribing by dentists which were cited in 30 of the 37. These attitudes most frequently identified by dentists were: complacency (22/29); lack of trust (16/29); the need to postpone the dental procedure (17/29); and fear (8/29). Gaps in knowledge were also identified (15/29). Only one of the included articles quantified the influence between the reported modifiable factors and antibiotic prescribing. The review emphasizes that dentists' antibiotic prescribing is predominantly influenced by modifiable factors. This insight informs the potential for targeted interventions to curtail inappropriate antibiotic use, contributing to global efforts in reducing antibiotic resistance. The protocol of this systematic review can be found in PROSPERO under registration no. CRD42021253937. • Factors associated with antibiotics prescribing in dentistry are modifiable. • Attitudes like complacency or lack of confidence influence antibiotic prescribing. • Educational interventions based on identified factors would improve prescriptions. [ABSTRACT FROM AUTHOR]

Background. Dental caries is a major public oral infectious disease globally due to its high prevalence and significant social impact. Many studies have been conducted on dental caries in Ethiopia; however, they fail to convey the antimicrobial resistance in the oral environment. Objective. This study was conducted to determine the antimicrobial susceptibility patterns and biofilm formation in the bacteria isolated from dental caries and its associated factors of dental caries in THE Ayder Comprehensive Specialized Hospital and private dental clinics located at Mekelle, Ethiopia. Methods. A cross-sectional study was conducted from September 2019 to October 2020. Sociodemographic characteristic, behavioral, and clinical data were collected using structured questionnaires. A total of 422 dental caries-suspected patients were selected and coronal caries scraps were collected by the dentist aseptically; these samples were transported to a microbiological laboratory to identify the antibiotic sensitivity assay and biofilm formation by the isolated pathogens. The data was analyzed using SPSS version 22. The P value of ≤0.05 was considered statistically significant. Results. The overall prevalence of culture-positive samples was found to be 196 (46.4%). From the 196 culture-positive samples, 327 bacteria were isolated. Out of 327 bacterial isolates, 196 (46.4%) were identified as Streptococcus mutans and 69 (35.2%) were identified to be Staphylococcus aureus. From the isolated bacteria, 311 (95.1%) organisms were identified as positive for biofilm formation. From the AST assay, we have identified that penicillin has the highest resistance rate of 76.5%, followed by tetracycline at 64.8%. In contrast, the antibiotics such as cefoxitin and chloramphenicol have a sensitivity of 83.5% and 81.6% to all the bacterial isolates. The overall prevalence of multidrug resistance (MDR) in the isolates was found to be 40.4%. With respect to the associated risk factors, the white spot (AOR = 3.885 , 95% CI 1.282-11.767, P = 0.016), gum bleeding (AOR = 2.820 , 95% CI 1.006-7.907, P = 0.049), toothache (AOR = 2.27 , 95% CI 0.58-0.885, P = 0.033), and chocolate consumption (AOR = 5.314 , 95% CI 1.760-16.040, P = 0.003) were statically associated with dental caries bacterial infection. Conclusion. Based on our findings, we recommend the integration of routine culture and AST into clinical practice that might support the diagnosis and management of MDR in dental caries. The education on proper dietary habits might support the prevention and control of dental caries. It is important to provide health education on how to improve oral health in the study area. The education on proper dietary habits might support the prevention and control of dental caries. Further study is needed to find the other determinant factors of dental caries. [ABSTRACT FROM AUTHOR]

In the absence of a full spectrum of evidence-based guidelines for the appropriate use of antimicrobial agents, dentists, including periodontists, remain a highly frequent antibiotic prescribing group. With the goal of understanding antibiotic prescribing practices, the authors surveyed a convenience sample of dental practitioners and periodontists to identify differences between the 2 cohorts and assess the factors that affect prescribing practices. An institutional review board–approved 15-item survey was developed to capture antibiotic prescribing practices addressing the main research question, factors affecting systemic antibiotic prescription patterns, and prescription timing. The authors collaborated with the American Dental Association (ADA) and the American Academy of Periodontology (AAP) for survey dissemination. Responses were summarized using descriptive statistics. Multivariable models were developed to identify antibiotic prescription predictors. Overall, 32.4% of the participants prescribed systemic antibiotics with scaling and root planing. When comparing the 2 groups, the authors found that 46.4% and 18.7% of the AAP and ADA members, respectively, prescribed systemic antibiotics with scaling and root planing (P =.0001). The authors found a significant difference between the AAP and ADA groups in prescription timing (P =.01). The multivariable model revealed that practitioner sex (P =.03), AAP membership (P =.0001), and years of practitioner experience (P =.04) predicted antibiotic prescription practices. The geographic location, practice setting, and occupation type did not predict antibiotic prescription patterns. The authors found a lack of clarity related to prescription timing, factors determining prescription patterns, and selection of patient population who would benefit more from antibiotics. This study confirmed a lack of clarity related to antibiotic prescription patterns in combination with nonsurgical periodontal treatment. [ABSTRACT FROM AUTHOR]

Pregnancy is a unique time in a woman's life with many physiological, physical, emotional and hormonal changes occurring. It can also be quite an anxious time for women particularly in the first trimester when the risk of miscarriage is at its highest. Uncertainty still exists around the topic of dental treatment and care during pregnancy, which may create challenges for both the patient and the dental team. CPD/Clinical Relevance: The treatment options available when managing pregnant patients and for safe prescribing for this population are described. [ABSTRACT FROM AUTHOR]

Objective. This study evaluates dentists' antibiotic prescribing habits and the frequency of facing patient pressure for prescriptions. Methods. An online anonymous survey was used to collect data on antibiotic prescribing practices, including prescribing unnecessary antibiotics if requested by patients. Results. The study population included 345 dentists; 227 (65.8%) were females and 118 (34.2%) were males. 54 (15.7%) reported that they prescribed unnecessary antibiotics more than once per week, 47 (13.6%) once per month, 135 (39.1%) rarely, and 109 (31.6%) never prescribed unnecessary antibiotics. 117 (33.9%) reported being pressured by patients to prescribe unnecessary antibiotics more than once per week. 110 (31.9%) reported being pressured by patients to do so at least once per month. There was a statistical difference between the two genders (P < 0.001) in reporting that patients pressured them to prescribe antibiotics when antibiotics were not necessary for treatment or prophylactic purposes and in prescribing unnecessary antibiotics sometimes if requested by a patient (P = 0.008). In addition, there was a statistical difference in dentists' confidence in their knowledge and practice in the area of antibiotic prescribing (P < 0.001). Conclusions. The results show that unnecessary antibiotic prescribing by dentists can be influenced by patient pressure. [ABSTRACT FROM AUTHOR]

Background Private practice dentists represent 72% of United States dentists. We conducted a prospective cohort study of private practice dentists comparing antibiotic use before and after dental antibiotic stewardship education by infectious diseases (ID) antibiotic stewardship experts. Methods Study phases were as follows: phase 1 (preeducation), 3 months of retrospective antibiotic data and a presurvey assessed baseline antibiotic knowledge; phase 2 (education), dentists attended 3 evening Zoom sessions; phase 3, (posteducation/interventions), 3 months of prospective audits with weekly feedback; phase 4, postsurvey and recommendations to reach more dentists. Results Fifteen dentists participated. Ten had practiced >20 years. Presurvey, 14 were unfamiliar with dental stewardship. The number of antibiotic prescriptions pre/post decreased from 2124 to 1816 (P  < .00001), whereas procedures increased from 8526 to 9063. Overall, appropriate use (prophylaxis and treatment) increased from 19% pre to 87.9% post (P  < .0001). Appropriate prophylaxis was 46.6% pre and 76.7% post (P  < .0001). Joint implant prophylaxis decreased from 164 pre to 78 post (P  < .0001). Appropriate treatment antibiotics pre/post improved 5-fold from 15% to 90.2% (P  = .0001). Antibiotic duration pre/post decreased from 7.7 days (standard deviation [SD], 2.2 days) to 5.1 days (SD, 1.6 days) (P  < .0001). Clindamycin use decreased 90% from 183 pre to 18 post (P  < .0001). Postsurvey responses recommended making antibiotic stewardship a required annual continuing education. Study participants invited ID antibiotic stewardship experts to teach an additional 2125 dentists via dental study clubs. Conclusions After learning dental antibiotic stewardship from ID antibiotic stewardship experts, dentists rapidly optimized antibiotic prescribing. Private practice dental study clubs are expanding dental antibiotic stewardship training to additional dentists, hygienists, and patients across the United States. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance is one of the most pressing public health problems. Health authorities, patients, and health professionals, including dentists, are all involved in its development. COVID-19 pandemic restrictions on dental care may have had repercussions on antibiotic prescribing by dentists. The aim of this study was to assess the impact of the COVID-19 pandemic on antibiotic prescribing by dentists, and to review antibiotic consumption according to the WHO Access, Watch, Reserve classification. We conducted a natural, before-and-after, quasi-experimental study, using antibiotic prescription data covering the period from January 2017 to May 2021. A segmented regression analysis with interrupted time series data was used to analyse the differences between the numbers of defined daily doses (DDD) of antibiotics prescribed monthly. The outcomes showed an immediate significant decrease in overall antibiotic prescribing by primary-care dentists during lockdown, followed by a non-significant upward trend for the next year. This same pattern was, likewise, observed for Access and Watch antibiotics. COVID-19 pandemic restrictions on dental care influenced the prescription of antibiotics. During confinement, an initial decrease was observed, this trend changed when in person consultations were recovered. It might be beneficial to analyse the prescription of antibiotics using the WHO AWaRe classification, in order to monitor their appropriate use. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether an educational intervention could improve antibiotic prescribing among Lebanese dentists and assess antibiotic prescribing patterns regarding international guidelines. Materials and methods: An interventional randomized controlled trial was conducted from the first of April to the end of August 2017. This was an oral presentation of about 20 min based on a review of the literature and the international guidelines. Sixty dentists specializing in oral dental surgery or general practitioners participated in this study. All the patients who took a consultation over 2 months were involved. Results: In this study, 950 antibiotic prescriptions were analyzed. A change was found only in antibiotics prescribed for tooth extraction and tooth extraction (impacted tooth). The intervention was impactful in raising the mean percentage of prescriptions compliant with indication and with the choice regarding antibiotics prescribed for prophylactic reasons. A dentist in the intervention group would have after the intervention period a mean percentage of prescriptions compliant with indication and with choice of 31.7% and 20.7%, respectively, above one in the control group. Despite the decrease in the overall number of antibiotics prescribed by dentists in the intervention group over time, this does not suggest that this was solely due to the effect of the intervention. Conclusion: This study highlights the importance of continuing medical education to optimize antibiotic use in dentistry. Clinical relevance: This study can serve as the basis for a future audit, training, and feedback intervention to increase dentists' awareness of recommended guidelines and optimal antibiotic use. [ABSTRACT FROM AUTHOR]

This study aims to examine the antibiotics prescription in endodontic infections amongst dentists. The questionnaire was carried out by asking 149 Iraqi dentists to fill out an online form, which was sent to them through several social media platforms. The paper-based questionnaire composed of seven questions was distributed to dentists. A statistically significant difference (P<0.05) was identified among dentists with different years of experience in terms of antibiotic prescription among patients with endodontic infection. Surprisingly, when asked to decide on the correct prescription suitable for patients without medical allergy, 51.68% selected the wrong prescription as the answer and 48.32% selected the correct one. While for the patients with medical allergies, there was a significant difference (P<0.05) among dentists who have many years of experience who selected the best answer in terms of the antibiotic prescription for allergic patients. The endodontic infection can be treated by cleaning the root canal system to remove the intracanal infection. However, over-prescribed antibiotics are still prevalent without any rational justification and antibiotic abuse is spreading globally leading to microbial antibiotic resistance. [ABSTRACT FROM AUTHOR]

Little is known about factors that influence dentists' decision making concerning antibiotic prophylaxis (AP) prescribing. The objective of this study was to determine factors that influence dentists' AP prescribing habits in patients at risk of developing infective endocarditis and prosthetic joint infections. A questionnaire was administered to 3,584 dentist members of The National Dental Practice-Based Research Network. In addition to descriptive statistics, ordinal regression models were used to determine the factors most likely to impact dentists' decisions to prescribe AP. Overall, 2,169 (61%) dentists in The National Dental Practice-Based Resesarch Network responded. Responders' decisions to prescribe antibiotics were influenced primarily by official guidelines, scientific literature, and physician or medical specialist opinion. Regarding potential risks, the greatest level of concern was for the development of infective endocarditis or prosthetic joint infections. Although litigation was deemed problematic, more than 90% of responders indicated a strong concern for the best course of action for the patient's health. Dentists also indicated a high level of concern about the potential for generating antibiotic-resistant bacteria with AP use and increased risk of adverse drug reactions. Dentists' AP decision making seems most influenced by official guidelines, scientific literature, and advice from a physician or medical specialist. These results suggest that one of the most effective means for promoting concordance of dentists clinical practice with the scientific basis for AP is to emphasize the importance and clarity of American Heart Association and American Dental Association recommendations and antimicrobial stewardship regarding prevention of infective endocarditis and prosthetic joint infections. [ABSTRACT FROM AUTHOR]

In France, despite several successive plans to control antimicrobial resistance, antibiotic use remains high in the outpatient setting. This study aims to better understand outpatient antibiotic use and prescription in order to identify tailored targets for future public health actions. Using data from the French National Health Data System, we described and compared the individual characteristics of patients with and without an antibiotic prescription. The prescribed antibiotics (ATC-J01) were detailed and compared between 2019 and 2020. Antibiotic prescribing indicators that take prescriber activity into account were estimated and compared. Patients who were female, advanced age, and the presence of comorbidities were associated with antibiotic prescriptions. The overall prescription rate was estimated at 134 per 1000 consultations and 326 per 1000 patients seen in 2019. General practitioners (GPs), dentists and paediatricians were associated with 78.0%, 12.2% and 2.2% of antibiotic prescriptions, respectively, with high prescription rates (391, 447, and 313 p. 1000 patients seen, respectively). In comparison with 2019, this rate decreased in 2020 for paediatricians (−30.4%) and GPs (−17.9%) whereas it increased among dentists (+17.9%). The reduction was twice as high among the male prescribers than among their female counterparts (−26.6 and −12.0, respectively). The reduction in prescriptions observed in 2020 (−18.2%) was more marked in children (−35.8%) but less so among individuals ≥65 years (−13.1%) and those with comorbidities (−12.5%). The decrease in penicillin prescriptions represents 67.3% of the overall reduction observed in 2020. The heterogeneous decrease in prescriptions by age and antibiotic class could be explained by the impact of COVID-19 control measures on the spread of respiratory viruses; thus, a substantial proportion of the prescriptions avoided in 2020 is likely inappropriate, particularly among children. In order to keep the rate of prescriptions comparable to that observed in 2020, male prescribers, paediatricians and GPs should be encouraged to maintain that level, while a campaign to raise awareness of the appropriate use of antibiotics should be aimed at dentists in particular. [ABSTRACT FROM AUTHOR]

Rising antibiotic use is a serious threat to the success of therapy in dentistry for bacterial resistance and side effects to the patients. The dentist community in Albania prescribing too many antibiotics. This survey assesses the mode of antibiotic use among Albanian dentists, with appropriate dosage and regimen, and antibiotic stewardship and their knowledge of relevant guidelines. Material and Methods: This survey study was conducted among 180 Albanian dentists. The questionnaire was distributed through e-mail addresses found in the database of the Faculty of Dental Medicine, University of Medicine of Tirana. We assessed 180 dentists out of which 154 (85.56%) completed the entire questionnaire. Results: There were 24,870 prescriptions in adult patients from 154 dentists for a period of six months with an average of 1,243 prescriptions per week. The most used antibiotics were fixed combinations of amoxicillin–clavulanic acid (67.43%) and azithromycin (39.3%) for allergic patients to beta-lactams. The results for antibiotic stewardship were incorrect in 37.01% of total providers, and gastrointestinal disorders were reported as side effects. Conclusion: This survey conducted among Albanian dentists shows a different trend of using antibiotics than in other countries. To tackle the current antibiotic resistance, dentists must be an important part of the antimicrobial stewardship program of the Public Health Institution in Albania to change individual behavior. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is assigned as a menace by the WHO (World Health Organization) where diseases resulting from multidrug-resistant bacteria are refractory to treatment as a result of a scarcity of new antibiotics in the queue. Antibiotic stewardship program is one of the worldwide strategies to advertise responsible use of antibiotics to halt AMR. The world has started facing a postantibiotic era without immediate and integrated action. Common infections which were treatable for decades can once again kill. The dentistry contributions towards antibiotic resistance are substantial. Approximately 10% of all common antibiotics are prescribed by dentists. Antimicrobial stewardship is a policy that can assist us in addressing the problems of antibiotic resistance. It is a framework that promotes the truly sustainable use of antimicrobials in dentistry. It refers to the approach which is multifaceted and incorporates policies, and guidelines along with surveillance, reports of prevalence and education, and audit of practice for reducing prescribing, adopted by health care organizations. The prime strategy is to improve clinical results while mitigating unintended consequences such as toxicity, pathogenic organism selection, and resistance emergence. Such issues should be centralized and the ongoing need to identify and convert “responsible usage” into context-specific and time-specific behavior. The importance of the antibiotic stewardship program, its team, and their action has become a challenge for the dental hospital but along with it, there are numerous opportunities to achieve the goal.

Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists' awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar's tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics. [ABSTRACT FROM AUTHOR]

Background: Prescribing antibiotics (Abs) as a prophylactic before dental procedures is recommended by the American Academy of Pediatric Dentistry (AAPD) in patients with cardiac diseases to prevent a potentially life-threatening infection of the cardiac valves or endocardium called "infective endocarditis (IE)." Aim: This study aimed to assess the compliance of dentists in Makkah city with the AAPD recommendations of prescribing prophylaxis Abs for special care pediatric patients at risk of having IE. Materials and Methods: This was an observational cross-sectional study among dentists who are working at the major hospitals in Makkah city, Saudi Arabia. Participants' perception regarding the prescription of prophylactic Abs was measured using validated and reliable questions. The reliability analysis was used with a model of alpha (Cronbach) to study the properties of measurement scales and the items that compose the scales and the average inter-item correlation. Results: One hundred and thirty-two dental practitioners were participated. Dental care providers would prescribe Abs with dental extraction (92.4%), periodontal surgery (89.4%), nonsurgical root canal treatment beyond apex (77.3%), supragingival scaling (67.4%), and retraction cord placement (46.2%). On the other hand, dental practitioners would not prescribe Abs for orthodontic appliance (87.9%), intraoral radiograph (87.1%), primary teeth shedding (81.8%), tooth preparation when taking an oral impression (76.5%), local anesthesia infiltration (68.2%), and restoration of Class II caries with matrix and wedge (56.8%). A significantly lower knowledge score was obtained by general dental practitioners when compared with consultant and specialists (P = 0.044). Consultants and specialists recorded significantly lower knowledge on the prescription of prophylaxis Abs for Class II caries with matrix and wedge (P < 0.001) when compared with general dental practitioners. Conclusions: Most dentists followed the AAPD recommendations of prophylactic Abs for children who have a high risk of developing IE. However, Class II dental restorations with matrix and wedge and placement of retraction cord have recorded more invalid responses. General dental practitioners had lower knowledge when compared with consultants and specialists when prescribing Abs for children who have a high risk of developing IE. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is assigned as a menace by the WHO (World Health Organization) where diseases resulting from multidrug-resistant bacteria are refractory to treatment as a result of a scarcity of new antibiotics in the queue. Antibiotic stewardship program is one of the worldwide strategies to advertise responsible use of antibiotics to halt AMR. The world has started facing a postantibiotic era without immediate and integrated action. Common infections which were treatable for decades can once again kill. The dentistry contributions towards antibiotic resistance are substantial. Approximately 10% of all common antibiotics are prescribed by dentists. Antimicrobial stewardship is a policy that can assist us in addressing the problems of antibiotic resistance. It is a framework that promotes the truly sustainable use of antimicrobials in dentistry. It refers to the approach which is multifaceted and incorporates policies, and guidelines along with surveillance, reports of prevalence and education, and audit of practice for reducing prescribing, adopted by health care organizations. The prime strategy is to improve clinical results while mitigating unintended consequences such as toxicity, pathogenic organism selection, and resistance emergence. Such issues should be centralized and the ongoing need to identify and convert "responsible usage" into context-specific and time-specific behavior. The importance of the antibiotic stewardship program, its team, and their action has become a challenge for the dental hospital but along with it, there are numerous opportunities to achieve the goal. [ABSTRACT FROM AUTHOR]

Aim: To assess the views of the dental interns (DIs) and general dental practitioners (GDPs) in the Asir region of Saudi Arabia on antibiotic prescription for endodontic therapy. Methods: The link to a cross-sectional online survey with 16 quantitative and qualitative questions was e-mailed to 60 DIs at the College of Dentistry of King Khalid University (group 1 [G1]) and 60 GDPs at the governmental primary healthcare centers in the Asir region of Saudi Arabia (group 2 [G2]). The data obtained from the survey were then subjected to a comparative statistical analysis. The inter-group statistical comparison of the distribution of categorical variables was tested using the chi square test or the Fisher's exact probability test if more than 20% of the cells had an expected frequency of less than 5. The p-values > 0.05 were considered statistically significant. The data were statistically analyzed using Statistical Package for Social Sciences (SPSS version 22.0, IBM Corporation, USA) for MS Windows. Results: The response rate was 83.3% for G1 and 63.33% for G2. Of the participants in G2, 39.5% had 1– 5 years' clinical experience (the participants in G1 had no clinical experience). The number of endodontic emergency patients seen per day was significantly higher in G1 (88% and 63.2% of the participants in G1 and G2, respectively, were seeing 0– 3 endodontic emergency patients per day). There was an insignificant difference between G1 and G2 in awareness of the existence of antibiotic prescription guidelines in endodontic therapy (57.9% and 56.0%, respectively; p > 0.05). There was also an insignificant difference between the groups in the rate of antibiotic prescription for endodontic problems, with 84% of the G1 participants and 86.8% of the G2 participants prescribing antibiotics only for limited patients. In the analysis of the clinical-vignette items (Q11– 16), it was found that the rate of antibiotic prescription did not significantly differ between G1 and G2 (p > 0.05). No significant difference was found in the rate of antibiotic prescription for symptomatic reversible pulpitis, symptomatic irreversible pulpitis, and chronic apical periodontitis cases (p > 0.05). In contrast, the rate of antibiotic prescription for the symptomatic apical periodontitis, acute apical abscess, and systemic complications cases differed significantly (8% for G1 and 18.4% for G2, 54% for G1 and 76.3% for G2, and 98% for G1 and 73.7% for G2, respectively). Conclusion: No significant difference in the rate of antibiotic prescription was found between the DIs and GDPs in this study. However, both groups showed an inappropriate rate of antibiotic prescription for some endodontic conditions. Further and more extensive studies involving a wider geographical region and different colleges of dentistry in Saudi Arabia are recommended. [ABSTRACT FROM AUTHOR]