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种植体牙科中抗生素处方模式和欧洲牙医对抗生素耐药性的认识:一项基于问卷调查的研究。

Patterns of antibiotic prescription in implant dentistry and antibiotic resistance awareness among European dentists: A questionnaire-based study.

机构信息

Department of Orthodontics and Dentofacial Orthopedics, Charité - University Medicine Berlin, Berlin, Germany.

Department of Oral Surgery, University of Liverpool, Liverpool, UK.

出版信息

Clin Oral Implants Res. 2024 Jul;35(7):771-780. doi: 10.1111/clr.14285. Epub 2024 May 24.

Abstract

OBJECTIVES

Antimicrobial resistance is an alarming global public health concern, threatening the effective treatment of common infections. This phenomenon is driven by the improper prescription of antibiotics. This study aimed to elucidate the patterns of antibiotic prescription in implant dentistry among European dentists and their awareness of antibiotic resistance.

MATERIALS AND METHODS

An anonymous online validated questionnaire was distributed via e-mail to 6431 recipients through the European Association for Osseointegration. It comprised of 17 structured questions investigating demographic variables, working environment, clinical experience, attitude towards antibiotic prescription in particular in relation to implant dentistry and COVID-19 pandemic, and awareness of antibiotic resistance. Data were collected from April to May 2023.

RESULTS

281 dentists from 33 European countries completed the survey. Almost 80% affirmed to routinely prescribe antibiotics as prophylaxis as well as after dental implant placement, especially in medically compromised patients or in cases of bone grafting. Amoxicillin, alone (61%) or in combination with clavulanic acid (56%), was the most common antibiotic of choice. Awareness of penicillin resistance among respondents was high. For peri-implantitis treatment, more than half reported the use of systemic antibiotics. The large majority (95%) did not prescribe more antibiotics since the beginning of COVID-19 pandemic. Less than 40% declared to follow national guidelines for antibiotic prescription.

CONCLUSION

This survey revealed a high prescription rate of antibiotics in implant dentistry, despite the awareness about antibiotic resistance among the respondents. The development and adherence to European guidelines has been identified as a potential strategy for improving antimicrobial stewardship.

摘要

目的

抗生素耐药性是一个令人震惊的全球公共卫生问题,威胁着常见感染的有效治疗。这种现象是由于抗生素的不当处方引起的。本研究旨在阐明欧洲牙医在种植牙科中抗生素处方的模式及其对抗生素耐药性的认识。

材料和方法

通过欧洲骨整合协会向 6431 名收件人通过电子邮件匿名分发了一份在线验证问卷。它由 17 个结构化问题组成,调查了人口统计学变量、工作环境、临床经验、对抗生素处方的态度,特别是与种植牙科和 COVID-19 大流行有关的态度,以及对抗生素耐药性的认识。数据收集于 2023 年 4 月至 5 月。

结果

来自 33 个欧洲国家的 281 名牙医完成了调查。近 80%的人肯定会常规开抗生素作为预防措施,也会在牙科种植体放置后开抗生素,特别是在有医疗问题的患者或需要进行骨移植的情况下。阿莫西林单独使用(61%)或与克拉维酸联合使用(56%)是最常见的选择抗生素。受访者对抗生素耐药性的认识很高。对于种植体周围炎的治疗,超过一半的人报告使用了全身抗生素。绝大多数(95%)自 COVID-19 大流行开始以来没有开更多的抗生素。不到 40%的人表示遵守了国家抗生素处方指南。

结论

尽管受访者对抗生素耐药性有一定认识,但本调查显示种植牙科中抗生素的处方率很高。制定和遵守欧洲指南已被确定为改善抗菌药物管理的潜在策略。

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