Vasudavan Sivabalan, Grunes Brandon, Mcgeachie John, Sonis Andrew L
Dr. Vasudavan is a visiting lecturer, at the Department of Dentistry, Boston Children's Hospital, at the Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Mass., USA; and a senior research fellow, Department of Anatomy, Faculty of Science, at The University of Western Australia, Perth, Australia; or
Dr. Grunes is courtesy attending staff, Department of Dentistry, Boston Children's Hospital.
Pediatr Dent. 2019 Jan 15;41(1):25-30.
The purposes of this study were to investigate prescribing patterns of antibiotics for the management of common pediatric oral infections, and to and identify the independent predictors of antibiotic preference across different groups of dental practitioners in Massachusetts, USA. A cross-sectional survey assessed antibiotic prescribing practices of general dentists, pediatric dentists, endodontists, and oral surgeons based on a series of clinical scenarios where antibiotic coverage may be warranted. The appropriate therapeutic management of patients with facial cellulitis occurred across all clinical groups. Endodontists were least likely to prescribe antibiotics for patients with irreversible pulpitis, and those with pulpal necrosis with associated parulis. Seventy-four percent of respondents prescribed antibiotics for patients suffering from pericoronitis and trismus. With the exception of the management of facial cellulitis, adherence to published guidelines for the prescription of antibiotics is low. Specifically, antibiotics are being prescribed too often for patients with tooth pain or localized abscesses and infrequently when the systemic spread of infection is less obvious, such as with trismus but no fever. Universally promulgated guidelines formulated by professional bodies may lead to improved adherence and a reduction in negative outcomes resulting from the overprescription of antibiotics.
本研究的目的是调查用于治疗常见儿童口腔感染的抗生素处方模式,并确定美国马萨诸塞州不同牙科从业者群体中抗生素偏好的独立预测因素。一项横断面调查基于一系列可能需要使用抗生素的临床场景,评估了普通牙医、儿童牙医、牙髓病医生和口腔外科医生的抗生素处方行为。所有临床组对面部蜂窝织炎患者均采取了适当的治疗管理措施。牙髓病医生为患有不可逆性牙髓炎以及伴有龈瘘的牙髓坏死患者开具抗生素的可能性最小。74%的受访者为患有冠周炎和牙关紧闭的患者开具了抗生素。除了面部蜂窝织炎的治疗外,对抗生素处方遵循已发表指南的情况较差。具体而言,对于牙痛或局部脓肿患者,抗生素的开具过于频繁,而对于感染全身扩散不明显的情况,如牙关紧闭但无发热时,抗生素的开具则较少。专业机构普遍颁布的指南可能会提高遵循率,并减少因抗生素过度处方导致的负面后果。