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Objectives: Inappropriate prescription of antibiotics contributes to antibiotic resistance. Therefore, the objective of this study was to determine the awareness, attitudes, and intention to practice of dentists prescribing antibiotics in Colombia in order to design a virtual learning environment on this subject. Methods: In a descriptive study across seven cities, 700 dentists from different Colombian cities were requested to complete a validated questionnaire containing five sections: general information, awareness on antibiotic effectiveness and antibiotic resistance, attitudes regarding prescription decision, intention to practice concerning clinical cases, and complementary information. The level of awareness, attitudes, and intention to practice was determined and Chi-square test was used to determine the existence of significant differences among cities. Results: The majority of dentists showed a medium level regarding the number of correct answers on awareness (62.4 percent) and attitudes (88.7 percent) and a high level on intention to practice (91.7 percent). Common errors within the awareness section included the meaning of the term "antibiotic resistance" (35 percent) and most dentists were not convinced that such resistance could be derived from prescription of antibiotics (51.2 percent). In the attitudes section, only 45 percent declared that they prescribe antibiotics based mainly on symptoms, and the intention to practice section showed a significant percentage of unnecessary prescription (51 percent for pacemaker users) or absence of prescription (53.9 percent for ventricular septal defect) in antibiotic prophylaxis for infectious endocarditis (IE). Conclusion:The dentists interviewed should be trained and made aware of antibiotic resistance, microbiological and clinical foundations, and current antibiotic prophylaxis guidelines.

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.

RESUMEN. Introducción: el tratamiento odontológico debe considerar rigurosamente la cadena de asepsia para reducir el fracaso, incluso cuando se realizan procedimientos endodónticos. A pesar de ser una recomendación clave en este tipo de intervenciones, esta afirmación no tiene el suficiente alcance, debido a que algunos estudiantes y profesionales no consideran la esterilización de los núcleos antes de utilizarlos. Para ANALYSIS OF ENTEROCOCCUS FAECALIS, STAPHYLOCOCCUS AUREUS, AND CANDIDA ALBICANS IN CAST METAL CORES ANÁLISIS DE ENTEROCOCCUS FAECALIS, STAPHYLOCOCCUS AUREUS Y CANDIDA ALBICANS EN NÚCLEOS COLADOS EN METAL BASE

Introducción: los estudios en otros países reportan una prescripción inadecuada de antibióticos por parte de los odontólogos. El objetivo de este estudio es validar un cuestionario para medir los conocimientos, actitudes y prácticas de los odontólogos del Meta respecto a la prescripción de antibióticos. Métodos: el estudio consistió en 5 fases: 1. Diseño del instrumento con grupo focal. 2. Validez de contenido con un panel de expertos. 3. Prueba piloto con siete odontólogos. 4. Aplicación de la encuesta a 98 odontólogos, donde se determinó la confiabilidad, los índices psicométricos y la unidimensionalidad de las preguntas 5. Construcción de escalas para uniformizar los resultados. Resultados: en las fases 1 y 2, se diseñó un instrumento con un nivel adecuado de concordancia por parte de expertos (W de Kendalle en suficiencia: 0.68, concordancia: 0.69, relevancia: 0.72 y claridad: 0.81). En la fase 3 se detectó que la encuesta estaba muy extensa. En la fase 4, algunos ítems no cumplieron con indicadores psicométricos como la consistencia interna. Por tanto, se ajustó el instrumento a 36 ítems que cumplieron con todos los indicadores psicométricos [(correlación biserial > 0.0, índice de discriminación > = 0, índice de no respuesta entre 0-0.15 y unidimensionalidad (p = 0.93)] y con una consistencia interna global buena (KR = 0.81). En la fase 5, se establecieron los niveles de calificación. Conclusiones: el cuestionario desarrollado en este estudio es válido en términos de confiabilidad, índices psicométricos y unidimensionalidad. Así mismo, presentó adecuados índices de no respuesta y de confiabilidad, y una escala sencilla de calificación.