School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Int Endod J. 2018 Jul;51(7):717-728. doi: 10.1111/iej.12887. Epub 2018 Feb 8.
To evaluate the views of final year dental surgery students (BDS; G1) at Cardiff University and general dental practitioners (GDPs; G2) within the geographic area of Cardiff, Wales, on antibiotic prescribing for endodontic conditions, and investigate the potential differences between the two groups.
A cross-sectional online questionnaire-based survey of 12 qualitative and quantitative questions was distributed to 76 final year BDS Cardiff University students and 55 dental practices within Cardiff, UK. Six questions recorded general information, and the remaining questions included a series of hypothetical clinical scenarios, where the participants were asked to state whether they would or would not prescribe antibiotics. The data were analysed using spss version 23 to produce descriptive statistics, contingency tables and to run chi-square (χ²) tests, Fisher's exact tests and relative risk calculations.
The response rate was 60% (n = 79). All G1 participants were aware of the consequences of antibiotic overuse. Approximately 60% of responders were aware of guidelines for antibiotic use in endodontic therapies, and 83% would only use antibiotics for a limited selection of patients (e.g. patients with systemic complications). G1 responses to clinical scenarios indicated overall that they were comparable to the ideal answers except for acute apical abscess (64% believed that antibiotics were indicated). The majority of G2 were aware of the consequences of antibiotic overuse. Only 28% of G2 were aware of guidelines for antibiotic use in endodontic therapies. Overall responses revealed that antibiotics would be prescribed for: systemic complications (78%), acute apical abscess (72%) and symptomatic apical periodontitis (28%). The clinical scenarios revealed G1 were more likely to prescribe antibiotics compared to G2 for cases of necrotic pulp with symptomatic apical periodontitis without systemic complications (incorrect answer) and less likely to other clinical scenarios such as necrotic pulp and asymptomatic apical periodontitis for patients with a history of rheumatic fever (ideal answers), symptomatic irreversible/reversible pulpitis, failure to achieve anaesthesia, chronic apical abscess for patients with diabetes. The recognition of antibiotic prescription for cases with signs of spreading infection was more evident in G2.
Final year undergraduate students were aware of the antibiotic resistance crisis, although a third was not aware of guidelines for use of antibiotics in endodontic conditions; their responses to clinical scenario were generally compatible with the guidelines. General dentists were less aware of the implications of overuse of antibiotics and the existence of guidelines, and their responses were occasionally incompatible with antibiotic guidelines for endodontic therapies.
评估卡迪夫大学口腔外科学（BDS；G1）应届毕业生和威尔士卡迪夫地区普通牙科医生（GDP；G2）对根管治疗中抗生素使用的看法，并探讨两组之间的潜在差异。
对卡迪夫大学 76 名口腔外科应届毕业生和英国卡迪夫的 55 家牙科诊所进行了横断面在线问卷调查，共 12 个定性和定量问题。其中 6 个问题记录了一般信息，其余问题包括一系列假设的临床情况，参与者被要求说明他们是否会或不会开抗生素。使用 spss 版本 23 对数据进行分析，以产生描述性统计数据、列联表，并进行卡方（χ²）检验、Fisher 确切检验和相对风险计算。
回复率为 60%（n=79）。所有 G1 参与者都意识到抗生素过度使用的后果。约 60%的应答者了解根管治疗抗生素使用指南，只有 83%的应答者会为有限的患者（如患有全身并发症的患者）使用抗生素。G1 对临床情况的反应表明，除急性根尖脓肿（64%认为需要使用抗生素）外，总体上与理想答案相当。大多数 G2 都意识到抗生素过度使用的后果。只有 28%的 G2 了解根管治疗抗生素使用指南。总体反应表明，抗生素将被用于：全身并发症（78%）、急性根尖脓肿（72%）和有症状的根尖牙周炎（28%）。临床情况表明，G1 比 G2 更有可能为有症状的根尖牙周炎且无全身并发症的坏死牙髓（错误答案）开抗生素，不太可能为其他临床情况（如坏死牙髓和无症状的根尖牙周炎）开抗生素，这些情况适用于有风湿热病史的患者（理想答案）、有症状的不可逆/可逆牙髓炎、无法达到麻醉效果、糖尿病患者的慢性根尖脓肿。G2 更能识别出有扩散感染迹象的病例需要开抗生素。
应届本科生意识到了抗生素耐药危机，尽管三分之一的人不知道根管治疗中使用抗生素的指南；他们对临床情况的反应通常与指南相符。普通牙医对过度使用抗生素的影响和指南的存在认识不足，他们的反应有时与根管治疗抗生素指南不相符。
