Sivaraman Sujatha S, Hassan Mohamed, Pearson Julie M
Family Dental Center, Federally Qualified Health Center, Columbia, Mo;, USA.
Department of Pediatric Dentistry, Tufts University, Boston, Mass., USA. Department of Pediatric Dentistry, Holyoke Health Center, Holyoke, Mass., USA.
Pediatr Dent. 2013;35(7):546-9.
The purposes of this study were to: (1) examine the antibiotic prescribing practices of pediatric dentists and adherence to professional guidelines; and (2) assess their knowledge of and attitudes toward antibiotic resistance.
A cross-sectional survey regarding antibiotic use, resistance, and knowledge of antibiotic stewardship programs was emailed to 4,636 members of the American Academy of Pediatric Dentistry (AAPD).
987 surveys (21 percent) were completed; 984 were analyzed. Lack of adherence to AAPD antibiotic guidelines was noted. There was a trend toward overuse of antibiotics for the following conditions: irreversible pulpitis with (32 percent) and without vital pulp (42 percent); localized dentoalveolar abscess with (68 percent) and without draining fistula (39 percent); mitral valve relapse with regurgitation (43 percent); intrusion (15 percent); extrusion (13 percent); and rheumatoid arthritis (12 percent). Determinants of antibiotic use were: facial swelling (88 percent); pain relief (15 percent); unavailable appointment for several weeks (six percent); and parental satisfaction (four percent). Although 98 percent of respondents believed that antibiotic resistance is of growing concern, only 15 percent were aware of antibiotic stewardship programs.
AAPD members overprescribe antibiotics. Educational programs to increase knowledge of antibiotic resistance and stewardship programs should be implemented to increase adherence to professional guidelines.
本研究的目的是:(1)调查儿科牙医的抗生素处方行为及对专业指南的遵守情况;(2)评估他们对抗生素耐药性的了解和态度。
通过电子邮件向美国儿科学会(AAPD)的4636名成员发送了一份关于抗生素使用、耐药性及抗生素管理计划知识的横断面调查问卷。
共完成987份调查问卷(21%);对984份进行了分析。发现存在未遵守AAPD抗生素指南的情况。在以下病症中存在抗生素过度使用的趋势:伴有(32%)和不伴有活髓(42%)的不可逆性牙髓炎;伴有(68%)和不伴有引流瘘管(39%)的局限性牙槽脓肿;伴有反流的二尖瓣复发(43%);牙嵌入(15%);牙脱出(13%);以及类风湿关节炎(12%)。抗生素使用的决定因素为:面部肿胀(88%);缓解疼痛(15%);数周内无法预约(6%);以及家长满意度(4%)。尽管98%的受访者认为抗生素耐药性问题日益受到关注,但只有15%的人了解抗生素管理计划。
AAPD成员存在抗生素处方过量的情况。应实施教育计划以增加对抗生素耐药性和管理计划的了解,从而提高对专业指南的遵守程度。