Department of Microbiology, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia.
Department of Paediatric Dentistry, University of Rijeka Faculty of Dental Medicine, Rijeka, Croatia.
Microb Drug Resist. 2021 Nov;27(11):1482-1488. doi: 10.1089/mdr.2020.0478. Epub 2021 Apr 28.
The goal of this study was to investigate the differences in dentists' knowledge, attitudes, and practice regarding antibiotic use and resistance among two areas of Primorsko-Goranska County (P-GC), Croatia. A cross-sectional study based on a structured questionnaire that was given to 230 dental practitioners in outpatient settings of P-GC in 2018. The overall response rate was 68.3% (157/230) and 72.2% (83/115) in the city of Rijeka and 64.3% (74/115) in the rest of P-GC. Dentists from two areas of P-GC held similar knowledge about prescribing antibiotics and attitudes regarding antibiotic use ( > 0.05). Most of the dental practitioners chose penicillins (65.0% amoxicillin with clavulanic acid and 33.1% amoxicillin) as the first-choice antibiotic in patients with no medical allergies. The trend of prescribing amoxicillin decreases with the age of the dentists ( = 0.046). Clindamycin (86.6%) was the first choice for patients allergic to penicillin. Postgraduate education changed the attitude toward taking more time to consider whether or not an antibiotic is needed. Croatian dentists had a high awareness of antimicrobial resistance (99.4%). The most common situations for which dentists would prescribe antibiotics were periapical abscess (84.7%), periodontal abscess (72.6%), and implant placement (59.9%). Patient request or expectation (43.4%) and treatment uncertainty (41.5%) were found to be the main factors for prescribing antibiotics with more frequency. Although there is a high level of antimicrobial resistance awareness among dental practitioners, there is still too much overuse of antibiotics and personal responsibility for prudent antibiotic use should be increased. The results of this study indicate that antibiotics are frequently prescribed for indications where surgical treatment should be the first option and the broad spectrum antibiotic is the preferred treatment option.
本研究的目的是调查克罗地亚普里莫斯卡-戈拉什卡县（PGC）两个地区的牙医在抗生素使用和耐药方面的知识、态度和实践方面的差异。这是一项基于 2018 年在 PGC 门诊环境中向 230 名牙科从业者发放的结构化问卷的横断面研究。总体回复率为 68.3%（230 名中的 157 名），里耶卡市为 72.2%（115 名中的 83 名），PGC 其余地区为 64.3%（115 名中的 74 名）。来自 PGC 两个地区的牙医在开抗生素处方的知识和对抗生素使用的态度方面持相似观点（>0.05）。大多数牙科从业者在患者无医疗过敏的情况下选择青霉素类药物（65.0%为阿莫西林克拉维酸，33.1%为阿莫西林）作为首选抗生素。开阿莫西林处方的趋势随牙医年龄的增加而降低（=0.046）。对青霉素过敏的患者首选克林霉素（86.6%）。研究生教育改变了对是否需要使用抗生素的态度。克罗地亚牙医对抗微生物耐药性的认识很高（99.4%）。牙医最常开抗生素的情况是根尖脓肿（84.7%）、牙周脓肿（72.6%）和种植体植入（59.9%）。患者要求或期望（43.4%）和治疗不确定性（41.5%）被认为是更频繁开抗生素的主要因素。尽管牙科从业者对抗微生物药物耐药性的认识水平很高，但抗生素的过度使用仍然存在，应增强个人对抗生素的谨慎使用的责任感。本研究结果表明，抗生素经常被开用于应该首先选择手术治疗的适应症，广谱抗生素是首选的治疗方案。
