Knowledge and Pattern of Antibiotic and Non Narcotic Analgesic Prescription for Pulpal and Periapical Pathologies- A Survey Among Dentists

Abstract

Aim:The objective was to assess the knowledge and pattern of antibiotic and non narcotic analgesic prescription for pulpal and periapical pathologies among dentists, registered with IDA, in and around Hyderabad. Materials and Methods:Cross-sectional survey was conducted from January 2014 to February 2014 in and around Hyderabad, Andhra Pradesh, India. A questionnaire for this cross-sectional survey was designed for evaluating the knowledge and patterns of antibiotic and non narcotic analgesic prescription for pulpal and periapical pathologies. It included some demographic information, questions regarding clinical and non clinical factors, type of antibiotics and non narcotics analgesics prescribed were recorded. Data was computed and analysed using SPSS software. Descriptive statistics was performed. Results:The response rate for the study was 85%, 51.4% being males and 53.9% were pursuing post graduation. Of the respondents, 44.3% would prescribe medication with elevated body temperatures and evidence of systemic involvement, while 42.8% would prescribe medication for non clinical factors such as unsure of diagnosis. Necrotic pulp with acute apical periodontitis with swelling present and mod/severe preoperative symptoms was the most common condition identified for antibiotic therapy (56.4%). The first antibiotic of choice in patients with no medical allergies is amoxicillin, followed by amoxicillin and metronidazole. The first antibiotic of choice in case of allergic to penicillin was erythromycin. 55.1% and 37.3% would not prescribe antibiotic and analgesic after Root canal treatment respectively. The most commonly prescribed NSAID is Diclofenac (51.1%). Factors influencing the choice of analgesics among respondents is severity of pain (61.4%). 31.7% remained informed of current prophylactic practices through pharmaceutical companies followed by university training sessions and scientific societies (30.7%). Conclusion:The results of the present survey have demonstrated a lack of uniformity among the dental practitioners. All the clinicians should make themselves aware of the current guidelines available, to ensure highest degree of patient care.

Worldwide pattern of antibiotic prescription in endodontic infections

“…The authors concluded that 92% of the oral health‐care providers overprescribed antibiotics. Jayadev et al . studied the pattern of antibiotic prescription for pulpal and peri‐apical pathologies among Indian dentists.…”

“…Taking into account that dentists prescribe approximately 10% of all antibiotics commonly used, the impact of dentists in antimicrobial resistance is considerable. After analgesics, antibiotics are the drugs most commonly prescribed by dentists. A survey carried out in the UK in 2004 revealed that 40% of general dental practitioners prescribed antibiotics three times per week, and 15% prescribed them on a daily basis.…”

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“…Hence it is essential that the dentist has to take a complete medical history of the patient before treatment. But in a survey conducted in Hyderabad it was found that only 18.5% considered the medical condition of the patient 10 . (Fig.…”

Diş Hekimliğinde Akılcı Farmakoterapi Düzenleme Süreci

“…Bu ilaçların istenen ölçüde akılcı kullanıldığını söylemek güçtür (22,23). Yapılan araştırmalar diş hekimlerinin ilaç yazma kararı aldıkları endikasyonların sorgulanması gerektiğini, bununla ilgili belirli düzenlemelerin yapılması ihtiyacının bulunduğu gerçeğini açığa çıkarmıştır (24,25). Diş hekimleri arasında antibiyotik ve analjezikler başta olmak üzere ilaçların gereksiz/aşırı reçete edildiğine yönelik tartışmalar bulunmaktadır (26).…”

“…Analjezikler diş hekimliğinde yaygın kullanılan önemli bir ilaç gurubudur (23)(24)(25)35). Analjeziklerin kullanımı konusunda çeşitli AOİK sorunları yaşanmaktadır ve bunların halk sağlığını tehdit etme potansiyeli bulunmaktadır (23-25, 27, 30, 36-41).…”