Rodriguez-Núñez Antonio, Cisneros-Cabello Rafael, Velasco-Ortega Eugenio, Llamas-Carreras José María, Tórres-Lagares Daniel, Segura-Egea Juan José
Department of Odontoloy, School of Health Sciences, European University of Madrid, Madrid, Spain.
J Endod. 2009 Sep;35(9):1198-203. doi: 10.1016/j.joen.2009.05.031. Epub 2009 Jul 22.
The purpose of this study was to determine the prescribing habits of active members of the Spanish Endodontic Society (AEDE) with regard to antibiotics.
A one-page questionnaire was sent to the active members of the AEDE. Of the 508 surveys mailed, 158 surveys were returned, and 140 were found to be usable. The overall response rate was 31.1%. The data were analyzed by using descriptive statistics and chi-square tests of independence.
The average duration of antibiotic therapy was 6.8 +/- 1.8 days. In patients with no medical allergies, most of the responders (86.1%) selected amoxicillin as the first-choice antibiotic, alone (44.3%) or associated with clavulanate (41.8%); metronidazole-spiramycin and clindamycin were prescribed by 7.6% and 3.7% of the respondents. The first drug of choice for patients with an allergy to penicillins was clindamycin 300 mg (63.2%) followed by metronidazole-spiramycin (23.7%). For cases of irreversible pulpitis, 40.0% of respondents prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis, and no swelling, 52.9% prescribed antibiotics. Almost 21.5% prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract.
For the most part, the majority of the members of the AEDE were selecting the appropriate antibiotic for use in orofacial infections, but there are still many who are prescribing antibiotics inappropriately. The use of antibiotics for minor infections, or in some cases in patients without infections, could be a major contributor to the world problem of antimicrobial resistance.
本研究的目的是确定西班牙牙髓病学会(AEDE)活跃会员在抗生素处方方面的习惯。
向AEDE的活跃会员发送了一份单页问卷。在邮寄的508份调查问卷中,有158份被退回,其中140份被认为可用。总体回复率为31.1%。使用描述性统计和独立性卡方检验对数据进行分析。
抗生素治疗的平均持续时间为6.8±1.8天。在无药物过敏的患者中,大多数受访者(86.1%)选择阿莫西林作为首选抗生素,单独使用(44.3%)或与克拉维酸联合使用(41.8%);7.6%的受访者开具了甲硝唑-螺旋霉素,3.7%的受访者开具了克林霉素。对青霉素过敏的患者首选药物是300毫克克林霉素(63.2%),其次是甲硝唑-螺旋霉素(23.7%)。对于不可逆性牙髓炎病例,40.0%的受访者开具了抗生素。对于牙髓坏死、急性根尖周炎且无肿胀的情况,52.9%的受访者开具了抗生素。对于伴有慢性根尖周炎和窦道的牙髓坏死,近21.5%的受访者开具了抗生素。
在很大程度上,AEDE的大多数成员在选择用于口腔面部感染的合适抗生素,但仍有许多人抗生素处方不当。在轻微感染或某些情况下在无感染的患者中使用抗生素,可能是导致全球抗菌药物耐药性问题的一个主要因素。