Soheilipour Shimae, Dunne Stephen Michael, Newton Jonathon Timothy, Jabbarifar Seyed Ebrahim
Department of Oral Health Services Research & Dental Public Health, King's College London, London, United Kingdom.
J Evid Based Dent Pract. 2009 Dec;9(4):183-93. doi: 10.1016/j.jebdp.2009.07.001.
This study aimed to determine the knowledge and application of current expert recommendations on antibiotic prophylaxis (AP) to prevent infective endocarditis (IE) both in the United Kingdom and Iran.
The study used a 3-part postal questionnaire survey of dentists in the United Kingdom (n=467) and Iran (n=200) covering demographic data, antimicrobial prophylaxis prescribing habits for adults treated under local analgesia, and sources of information about recommended schedules and changes in dentists' prophylaxis regimens.
Most UK dentists (87%) reported following the British National Formulary guidelines (BNF) on AP. Seventy-five percent of Iranian dentists follow the guidelines of the American Heart Association (AHA). A significant proportion of practitioners prescribed the correct antibiotic regimens for patients who are nonallergic or allergic to penicillin in the United Kingdom, but in Iran the knowledge of and compliance with the available guidelines regarding antibiotic regimens was poor. Although dentists were familiar with the dental procedures that could place their patients at risk, and more than 80% prescribed prophylaxis for patients with "prosthetic heart valves" and "previous bacterial endocarditis," they also considered AP for patients with medical conditions not known to be at risk. For the UK dentists, the most common source of information on AP is medical and dental journals, whereas for Iranian dentists, academic meetings, colleagues, and textbooks were cited as sources of information on AP. Furthermore, 80% of participants in both countries would like to attend further courses about this topic.
Generally, dentists in the United Kingdom were more familiar with the current expert recommendations on AP than dentists in Iran; however, dentists in both countries tended to overprescribe. This could contribute to the problem of antimicrobial resistance. Educational initiatives aimed at implementing updated recommendations and continuous assessment of dental practice might reverse this trend.
本研究旨在确定英国和伊朗目前关于预防感染性心内膜炎（IE）的抗生素预防（AP）专家建议的知晓情况和应用情况。
该研究采用了三部分的邮寄问卷调查，对象为英国（n = 467）和伊朗（n = 200）的牙医，内容涵盖人口统计学数据、局部麻醉下治疗成人的抗菌药物预防处方习惯，以及关于推荐方案的信息来源和牙医预防方案的变化。
大多数英国牙医（87%）报告遵循英国国家处方集（BNF）关于AP的指南。75%的伊朗牙医遵循美国心脏协会（AHA）的指南。在英国，很大一部分从业者为非青霉素过敏或青霉素过敏患者开具了正确的抗生素方案，但在伊朗，对抗生素方案现有指南的知晓和遵循情况较差。尽管牙医熟悉可能使患者面临风险的牙科操作，并且超过80%的牙医为患有“人工心脏瓣膜”和“既往细菌性心内膜炎”的患者开具预防用药，但他们也为已知无风险的医疗状况患者考虑了AP。对于英国牙医来说，AP最常见的信息来源是医学和牙科期刊，而对于伊朗牙医来说，学术会议、同事和教科书被列为AP的信息来源。此外，两国80%的参与者希望参加关于该主题的进一步课程。
总体而言，英国牙医比伊朗牙医更熟悉目前关于AP的专家建议；然而，两国牙医都倾向于过度开药。这可能会导致抗菌药物耐药性问题。旨在实施最新建议和持续评估牙科实践的教育举措可能会扭转这一趋势。
