Šutej Ivana, Bašić Krešimir, Šegović Sanja, Peroš Kristina
Department of Pharmacology, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Antibiotics (Basel). 2024 Sep 12;13(9):873. doi: 10.3390/antibiotics13090873.
Prescribing antibiotics is a regular part of daily dental practice. Antibiotics have a significant but a limited role in general dental practice due to the threat of emergence of antimicrobial resistance (AMR). As such, the aim of this study was to assess prescribing trends in dental antibiotics use from 2014-2023 in Croatia. Data on antibiotic prescribing practices for this study were provided by the Croatian Health Insurance Fund. The analysis included the number of prescriptions, packages, cost, and the World Health Organization's defined daily dose per 1000 inhabitants (DID) per day as an objective utilization for comparison. Over the 10-year period, dentists in Croatia prescribed an annual average of 357,875 antibiotic prescriptions, representing an annual average of 78.7% of all dental prescriptions. The most commonly prescribed antibiotic was the combination of amoxicillin and the beta-lactamase inhibitor clavulanic acid, which made up 58.54% of antibiotics and 46.1% of all dental prescriptions. This was followed by amoxicillin (12.61%), clindamycin (12.58%), and metronidazole (9.96%). The trend showed two discontinuations, the first for the pandemic years, and the second caused by disruption in amoxicillin production. The rise in the use of broad-spectrum antibiotics needs to be addressed and regulated to ensure patients and dentists understand that antibiotics are not a substitute for dental treatment. Dentists should always begin treatment with narrow-spectrum antibiotics regardless of possible exceptional circumstances.
开具抗生素是日常牙科诊疗的常规组成部分。由于抗菌药物耐药性（AMR）出现的威胁，抗生素在一般牙科诊疗中作用显著但有限。因此，本研究的目的是评估2014年至2023年克罗地亚牙科抗生素使用的处方趋势。本研究的抗生素处方数据由克罗地亚健康保险基金提供。分析包括处方数量、包装、成本以及世界卫生组织定义的每1000名居民每日限定日剂量（DID），作为客观的使用量用于比较。在这10年期间，克罗地亚的牙医每年平均开具357,875份抗生素处方，占所有牙科处方的年平均比例为78.7%。最常开具的抗生素是阿莫西林与β-内酰胺酶抑制剂克拉维酸的组合，占抗生素的58.54%，占所有牙科处方的46.1%。其次是阿莫西林（12.61%）、克林霉素（12.58%）和甲硝唑（9.96%）。趋势显示出现了两次中断，第一次是在大流行年份，第二次是由阿莫西林生产中断导致。需要解决并规范广谱抗生素使用的增加，以确保患者和牙医明白抗生素不能替代牙科治疗。无论可能存在何种特殊情况，牙医都应始终先用窄谱抗生素开始治疗。
