科威特牙医治疗口腔疾病时的抗生素处方模式。

Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait.

作者信息

Salako N O, Rotimi V O, Adib S M, Al-Mutawa S

机构信息

Faculty of Dentistry, Kuwait University, P.O.Box 24923, Safat 13110, Kuwait.

出版信息

J Dent. 2004 Sep;32(7):503-9. doi: 10.1016/j.jdent.2004.04.001.

DOI:10.1016/j.jdent.2004.04.001

PMID:15304295

Abstract

OBJECTIVES

The use and abuse of antibiotics have been of concern to the medical and the dental profession for sometime now, due mainly to the emergence of antibiotic-resistant bacteria. The objective of this project was to determine the rationale and the pattern of antibiotic prescription for dental management in Kuwait.

METHODS

A questionnaire was distributed to 200 dental practitioners working in the Ministry of Health dental centers in Kuwait. The questionnaires sought answers to the clinical and non-clinical factors; signs, clinical conditions and dental treatment modalities for which the practitioners would prescribe antibiotics.

RESULTS

Of the 200 questionnaires sent out, 168 (84%) respondents returned fully completed forms. A total of 107 (63.7%) of the respondents were males. Of respondents, 90% would prescribe antibiotics for patients with elevated body temperatures and evidence of systemic involvement, gross or diffuse facial swelling and closure of the eye due to inflammatory swelling. However, over 50% would prescribe antibiotics for cases with localized fluctuant swelling without any systemic involvement, while 59.6% would prescribe for patients with difficulty in swallowing as a result of an oral infection. Many respondents would consider antibiotic prescription for routine dental extraction, and for non-clinical reasons such as uncertainty of diagnosis, convenience, expectation of the patient and lack of time to treat immediately. Amoxicillin was the most frequently prescribed antibiotic. Higher knowledge regarding adequate indications for antibiotic use was associated with longer professional experience.

CONCLUSIONS

The results of this analysis suggest that there is lack of uniformity in the rationale for antibiotic use among dental practitioners in Kuwait. There is an urgent need for the formulation of evidence-based guidelines, which should take into account the peculiar behavioral characteristics of the community.

摘要

目的

一段时间以来，抗生素的使用和滥用一直是医学和牙科领域关注的问题，主要原因是抗生素耐药菌的出现。本项目的目的是确定科威特牙科治疗中抗生素处方的基本原理和模式。

方法

向在科威特卫生部牙科中心工作的200名牙科医生发放了问卷。问卷寻求关于临床和非临床因素、医生会开具抗生素的体征、临床状况及牙科治疗方式的答案。

结果

在发出的200份问卷中，168名（84%）受访者返回了完整填写的表格。受访者中共有107名（63.7%）为男性。90%的受访者会为体温升高且有全身受累迹象、明显或弥漫性面部肿胀以及因炎症性肿胀导致眼睛闭合的患者开具抗生素。然而，超过50%的受访者会为局部波动性肿胀且无任何全身受累的病例开具抗生素，59.6%的受访者会为因口腔感染导致吞咽困难的患者开具抗生素。许多受访者会考虑为常规拔牙开具抗生素，以及出于非临床原因，如诊断不确定、方便、患者期望和缺乏立即治疗的时间等。阿莫西林是最常开具的抗生素。对抗生素使用适当指征的更高认知与更长的专业经验相关。