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一项关于罗曼地牙医系统使用抗生素处方的调查。

A survey on systemic antibiotic prescription among dentists in Romandy.

机构信息

Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

出版信息

Swiss Dent J. 2023 Dec 4;133(12):800-808. doi: 10.61872/sdj-2023-12-01. Epub 2023 Jul 13.

Abstract

Antimicrobial resistance (AMR) is a significant global health threat that arises from the excessive and incorrect use of antibiotics. As key players in the evolution of AMR, medical and dental practitioners are often questioned on their indications for antibiotic prescription during daily practice. The present survey aimed to evaluate self-reported practices regarding systemic antibiotic prescription among Swiss dentists in Romandy. An electronic questionnaire was sent to 331 dentists working in the French-speaking part of Switzerland and the responses were analyzed on a three-point Likert scale. The response rate was 28%. Results showed that the main indications for antibiotic use were abscesses with systemic symptoms (89%), cellulitis (81.5%), acute sinusitis (62%) and necrotizing periodontitis (52%). Surgical procedures most frequently combined with antibiotics were sinus floor elevation (59.8%) and implant placement (60.9%). Amoxicillin was the first-choice antibiotic, and clindamycin was mostly prescribed for patients with a penicillin allergy (87%). The majority of dentists recommended prophylaxis with 2g of amoxicillin, one hour before the procedure for patients with a high risk of endocarditis (82.6%), immunodeficiency / immunosuppression (50%), or joint replacement during the last year (47.8%). Most participants (76.1%) expressed the need for specific guidelines on the use of antibiotics in dentistry. The research findings suggested antibiotic prescriptions in dentistry could profit from stricter guidelines.

摘要

抗菌药物耐药性(AMR)是一个重大的全球健康威胁,它源于抗生素的过度和不当使用。作为 AMR 演变的关键参与者,医疗和牙科从业者在日常实践中经常被问及抗生素处方的适应症。本调查旨在评估瑞士罗曼语区牙医对自身系统用抗生素处方做法的报告。向在瑞士法语区工作的 331 名牙医发送了电子问卷,对其三点李克特量表的回答进行了分析。回复率为 28%。结果表明,使用抗生素的主要适应症是伴有全身症状的脓肿(89%)、蜂窝织炎(81.5%)、急性鼻窦炎(62%)和坏死性牙周炎(52%)。最常与抗生素联合使用的手术程序是鼻窦底提升术(59.8%)和种植体植入术(60.9%)。阿莫西林是首选抗生素,对于青霉素过敏的患者(87%),大多开克林霉素。大多数牙医建议在有高风险发生心内膜炎(82.6%)、免疫缺陷/免疫抑制(50%)或去年进行关节置换(47.8%)的患者中,在手术前一小时用 2g 阿莫西林进行预防。大多数参与者(76.1%)表示需要制定牙科抗生素使用的具体指南。研究结果表明,牙科抗生素处方可以从更严格的指南中受益。

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