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抗生素处方用于治疗和预防牙源性感染:立陶宛牙医的横断面调查。

Antibiotic Prescription for Treatment and Prevention of Odontogenic Infections: A Cross-Sectional Survey of Lithuanian Dentists.

机构信息

Clinic of Dental and Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.

Institute of Odontology, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.

出版信息

Medicina (Kaunas). 2024 Oct 24;60(11):1745. doi: 10.3390/medicina60111745.

Abstract

: The inappropriate use of antibiotics can lead to antimicrobial resistance. Overprescribing in dental practice has been reported. This study aimed to describe patterns of antibiotic prescription for treating and preventing odontogenic infections based on reports from Lithuanian dentists. : Questionnaires were sent to all 4751 Lithuanian dentists registered in the database of the Lithuanian Dental Chamber who had consented to participate in surveys. The questionnaire addressed antibiotic prescription preferences for the treatment and prevention of various dental pathologies. The statistical analysis included chi-square tests and a factor analysis to evaluate prescription frequences in different clinical scenarios considering the respondents' specialty and age. : Of 647 responses, 497 were from general dentists, 35 from oral surgeons, 40 from endodontists, 20 from periodontists, and 35 from prosthodontists. Respondents were grouped by age: A (≤35 years, n = 207), B (36-50 years, n = 224), and C (≥51 years, n = 209). Amoxicillin was the first-choice antibiotic for 81.1% of respondents (group A more frequently than other groups, = 0.001). A 7-day treatment duration was preferred by 60.8%, while 33.6% chose 5 days. For patients allergic to β-lactam antibiotics, 63% preferred clindamycin. Over 90% cited acute apical abscess with systematic involvement as an indication for antibiotic prescription. A factor analysis of 18 clinical scenarios revealed prescription differences among dental specialists, oral surgeons, and periodontists prescribing antibiotics more frequently than general dentists and endodontists. For prophylaxis, 87.5% recommended antibiotics for patients at risk of infectious endocarditis after a cardiologist's consultation (group C less frequently than other groups, = 0.021). : Lithuanian dentists generally prefer narrow-spectrum antibiotics for the treatment of odontogenic infections. There are notable differences in prescription patterns among dental specialists, with younger dentists showing a trend towards more rational antibiotic use.

摘要

: 抗生素的不当使用会导致抗菌药物耐药性。据报道,牙科实践中存在过度处方的情况。本研究旨在根据立陶宛牙医的报告,描述治疗和预防牙源性感染时抗生素处方的模式。 : 向在立陶宛牙科学会数据库中注册并同意参与调查的所有 4751 名立陶宛牙医发送了问卷。问卷涉及治疗和预防各种牙科疾病时抗生素处方的偏好。统计分析包括卡方检验和因子分析,以评估考虑到受访者专业和年龄的不同临床情况下的处方频率。 : 在 647 份回复中,497 份来自普通牙医,35 份来自口腔外科医生,40 份来自牙髓病学家,20 份来自牙周病学家,35 份来自修复科医生。受访者按年龄分组:A(≤35 岁,n=207),B(36-50 岁,n=224)和 C(≥51 岁,n=209)。81.1%的受访者首选阿莫西林(A 组比其他组更频繁,=0.001)作为首选抗生素。60.8%的人更喜欢 7 天的治疗疗程,而 33.6%的人选择 5 天。对于对β-内酰胺类抗生素过敏的患者,63%的人首选克林霉素。超过 90%的人指出系统受累的急性根尖脓肿是开具抗生素处方的指征。对 18 种临床情况进行因子分析后发现,口腔外科医生和牙周病学家与普通牙医和牙髓病学家相比,开具抗生素的处方存在差异。对于预防,87.5%的人建议在心脏病专家咨询后,有感染性心内膜炎风险的患者使用抗生素(C 组比其他组更不频繁,=0.021)。 : 立陶宛牙医通常选择窄谱抗生素治疗牙源性感染。牙科专家之间的处方模式存在显著差异,年轻牙医对抗生素使用的趋势更为合理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04a2/11596110/6a92dcd6a315/medicina-60-01745-g001.jpg

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