Lauber Carmen, Lalh Saranjeev S, Grace Michael, Smith Miller Hayden, MacDougall Kevin, West Paul, Compton Sean
J Can Dent Assoc. 2007 Apr;73(3):245.
A survey was conducted to determine prescribing practices of general dental and medical practitioners regarding the use of antibiotics for prophylaxis.
A questionnaire with an accompanying letter was designed to investigate prescribing practices of general dentists and physicians. The survey encompassed demographic data, mechanisms to keep current with prophylactic practice, first- and second-line drugs prescribed with doses and directions, applicable medical conditions and dental procedures warranting antibiotic prophylaxis. Names were chosen randomly from provincial lists and ethics approval was granted. Responses were compared with 1997 American Heart Association (AHA) guidelines.
In all, 1,500 surveys were sent to each group, with a response rate of 32% of dentists and 17% of physicians. There was a significant difference (p < 0.05) between dentists (95%) and physicians (71%) in selecting the correct first-line antibiotic, amoxicillin, and in choosing the correct dose of amoxicillin (i.e., 2 g, 1 hour before treatment): 88% of dentists and 48% of physicians (p < 0.05). Appropriate second-line drugs were correctly selected by 84% of dentists and 67% of physicians--a significant difference (p < 0.05)--with clindamycin chosen most often (82% and 49%, respectively). Over 90% of respondents in both professions correctly identified conditions, such as prosthetic heart valve and endocarditis, requiring antibiotic prophylaxis.
Clinicians are not always aware of current clinical guidelines, and dentists and physicians exhibit different patterns regarding antibiotic prescribing. Dentists are more familiar than physicians with current protocols of the AHA.
开展了一项调查，以确定普通牙科医生和医学从业者在使用抗生素进行预防方面的处方习惯。
设计了一份附有信函的问卷，以调查普通牙医和医生的处方习惯。该调查涵盖人口统计学数据、了解预防措施最新情况的机制、开具的一线和二线药物及其剂量和用法说明、适用的医疗状况以及需要抗生素预防的牙科手术。从省级名单中随机选取姓名，并获得了伦理批准。将调查结果与1997年美国心脏协会（AHA）指南进行了比较。
总共向每组发送了1500份调查问卷，牙医的回复率为32%，医生的回复率为17%。在选择正确的一线抗生素阿莫西林以及选择正确剂量的阿莫西林（即治疗前1小时服用2克）方面，牙医（95%）和医生（71%）之间存在显著差异（p<0.05）：88%的牙医和48%的医生（p<0.05）。84%的牙医和67%的医生正确选择了合适的二线药物，这一差异具有统计学意义（p<0.05），最常选择的是克林霉素（分别为82%和49%）。两个专业中超过90%的受访者正确识别了需要抗生素预防的状况，如人工心脏瓣膜和心内膜炎。
临床医生并不总是了解当前的临床指南，并且牙医和医生在抗生素处方方面表现出不同的模式。与医生相比，牙医更熟悉AHA的现行方案。
