Baqai Dental College, Baqai Medical University, Karachi, Pakistan.
Department of Community Medicine, Baqai Medical University, Karachi, Pakistan.
PLoS One. 2020 Jul 10;15(7):e0235671. doi: 10.1371/journal.pone.0235671. eCollection 2020.
Antibiotics are regularly prescribed by dental professionals in their practice, for the purpose of dental treatment as well as for the prevention of infection. The inappropriate use of antibiotics is a significant factor in the rise of antibiotic resistance. There is an immediate need for the advancement of prescribing guidelines and instructive polices to encourage the rational and appropriate utilization of medications especially antibiotics in dentistry.
The aim of this study was to identify the frequency of antibiotic prescription for treating dental infections in children among dentists in teaching institutions of Karachi, Pakistan and whether they are adhering to the prescribed international guidelines.
A cross-sectional study was conducted in three private and two public colleges of Karachi. After taking written informed consent and checking the inclusion criteria, a total of 380 participants were interviewed using a pre-designed validated questionnaire which included demographic profile and clinical case scenarios. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using chi-square test. The significance level was set at 0.05.
Of the 380 subjects, a majority (71.3%) treated 15 or less children per month (n = 271) while 28.7% of dentists (n = 109) treated more than 15 children per month. Overall adherence to American Academy of Pediatric Dentistry guidelines was low from 26.1% to 44.2%. The difference between adherence of dentists with low and high volume of pediatric patients was significantly different for case scenarios 1, 3, 4 and 5 (p<0.001 for all) where dentists who treated 15 or less children per month were more likely to be adherent to standard antibiotic prescription guidelines than those who treated more than 15 children per month.
This study shows that majority of dentists, particularly dentists with high volume of pediatric patients lacked adherence to professional guidelines for prescribing antibiotics for treating dental infection in children. There seem to be a lack of harmony between the recommended professional guidelines and the antibiotic prescribing pattern of dentists. Regular updates and continuing medical education for the health professionals regarding comprehensible and specific professional guidelines may lead to improved adherence of antibiotics prescription amongst dentists.
在口腔治疗实践中，牙医经常会开抗生素处方，目的是治疗口腔感染以及预防感染。抗生素的不当使用是抗生素耐药性上升的一个重要因素。当前，迫切需要制定处方指南和指导政策，以鼓励在口腔医学领域合理、恰当地使用药物，尤其是抗生素。
本研究旨在确定巴基斯坦卡拉奇教学机构的牙医治疗儿童口腔感染时开抗生素处方的频率，以及他们是否遵守既定的国际指南。
本研究采用横断面研究设计，在卡拉奇的三所私立学院和两所公立学院进行。在获得书面知情同意并检查纳入标准后，使用预先设计的、经过验证的问卷对 380 名参与者进行访谈，问卷内容包括人口统计学特征和临床病例情景。使用 SPSS 版本 20 输入和分析数据。使用卡方检验进行推断性分析。显著性水平设定为 0.05。
在 380 名受试者中，大多数（71.3%，n = 271）每月治疗 15 名或以下儿童，而 28.7%（n = 109）的牙医每月治疗 15 名以上儿童。总体而言，美国儿科学会口腔医学指南的遵循率较低，为 26.1%至 44.2%。在病例情景 1、3、4 和 5 中，治疗 15 名或以下儿童的牙医比治疗 15 名以上儿童的牙医更有可能遵循标准抗生素处方指南，其差异具有统计学意义（p<0.001）。
本研究表明，大多数牙医，尤其是儿童患者数量较多的牙医，在为儿童口腔感染开抗生素处方时，不遵守专业指南。推荐的专业指南与牙医的抗生素处方模式之间似乎存在不协调。针对口腔医学专业指南，为卫生专业人员提供定期更新和持续医学教育，可能会提高牙医对抗生素处方的遵循度。
