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意大利牙医在口腔种植术中的抗生素预防习惯:一项横断面调查。

Antibiotic prophylaxis habits in oral implant surgery among dentists in Italy: a cross-sectional survey.

机构信息

Department of Epidemiology and Public Health, University of the Basque Country (UPV/EHU), Bilbao, Spain.

Department of Oral Health Sciences, Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium.

出版信息

BMC Oral Health. 2019 Dec 2;19(1):265. doi: 10.1186/s12903-019-0943-x.

Abstract

BACKGROUND

The prescription of prophylactic antibiotics in conjunction with oral implant surgery remains inconsistent among different populations of dentists. The main objective of this study was to assess the current antibiotic prescribing habits of dentist in conjunction with oral implant surgery in Italy. The secondary objective was to assess the nature and amount (mg) of antibiotics prescriptions in order to evaluate whether any consensus has been reached and if the current recommendations are complied.

METHODS

Observational cross-sectional study based on a web-survey reported according to the STROBE guidelines. A questionnaire was sent via email to each registered member of the Italian Academy of Osseointegration (n = 400). The email included a link to the anonym web questionnaire developed on www.encuestafacil.com. It contained close-ended and some open-ended questions concerning demographics, antibiotic type, prescription duration and dosage. Collected data were analyzed using STATA® 14 software.

RESULTS

160 participants responded the survey (response rate = 40%). Approximately 84% routinely prescribed prophylactic antibiotics in conjunction with oral implant surgery, 15.6% prescribed antibiotics in certain situations and only 1 did not prescribe antibiotics at all. Overall, 116 respondents prescribed both pre- and postoperative antibiotics, 29 prescribed antibiotics only preoperatively and 14 prescribed antibiotics exclusively after surgery. Italian dentists prescribed an average amount of 10,331 mg antibiotics before, during or after oral implant surgery. Approximately, only 17% (n = 27) of the participants who prescribed antibiotics before oral implant surgery complied with the recommendations proposed by the latest publications (no more than 3 g of preoperative amoxicillin before oral implant surgery).

CONCLUSIONS

Dentists in Italy on a large scale prescribe antibiotic prophylaxis in conjunction with oral implant surgery among healthy patients. A high range of prophylactic regimens is prescribed and they are not adhering to the new science-based specifications. Guidelines focused on the indications for prophylactic antibiotics among healthy patients are required to prevent bacterial resistance, side effects and costs caused by overtreatment and the irrational use of antibiotics.

摘要

背景

在口腔种植手术中预防性使用抗生素的做法在不同牙医群体中仍存在不一致性。本研究的主要目的是评估意大利牙医在口腔种植手术中预防性使用抗生素的现状。次要目的是评估抗生素的使用种类(种类)和剂量(mg),以评估是否已经达成共识以及是否遵循了当前的推荐意见。

方法

本研究基于一项网络调查,采用 STROBE 指南进行报告,为观察性横断面研究。通过电子邮件向意大利骨整合学会(Italian Academy of Osseointegration)的每位注册成员(n=400)发送问卷。该电子邮件包含一个链接,链接指向在 www.encuestafacil.com 上开发的匿名网络问卷。问卷包含有关人口统计学、抗生素类型、处方持续时间和剂量的封闭式和一些开放式问题。使用 STATA® 14 软件分析收集的数据。

结果

共有 160 名参与者对调查做出了回应(应答率=40%)。大约 84%的牙医在口腔种植手术中常规预防性使用抗生素,15.6%的牙医在某些情况下使用抗生素,只有 1 名牙医根本不使用抗生素。总体而言,116 名牙医同时开具了术前和术后抗生素,29 名牙医仅开具了术前抗生素,14 名牙医仅开具了术后抗生素。意大利牙医在口腔种植术前、术中和术后平均开具 10331mg 抗生素。大约只有 17%(n=27)的在口腔种植术前开具抗生素的参与者遵循了最新出版物提出的建议(在口腔种植术前不超过 3g 阿莫西林)。

结论

意大利牙医在健康患者的口腔种植手术中广泛使用抗生素预防。所开具的预防性方案范围广泛,且他们并未遵循基于新科学的规范。需要针对健康患者预防性使用抗生素的适应证制定指南,以预防细菌耐药性、抗生素过度使用引起的副作用和费用以及抗生素的不合理使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b67/6889412/d94298e5d48a/12903_2019_943_Fig1_HTML.jpg

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