关于感染相关性口面部疼痛抗生素使用的系统评价方案：政策与实践意义
Systematic Review Protocol on Antibiotic Use for infection related Orofacial Pain: Policy and Practice Implications.
作者信息
Mehta Nishant, Shrivastava Richa, Patyal Neha, Gupta Arpit
机构信息
Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, 160012, India.
Oral health Sciences Centre, Postgraduate institute of Medical Education and Research, Chandigarh, Chandigarh, 160012, India.
出版信息
F1000Res. 2025 Jul 22;14:415. doi: 10.12688/f1000research.163353.2. eCollection 2025.
BACKGROUND
Dental pain and intraoral swelling, commonly resulting from pulpal and periapical infections, are leading causes of emergency visits. Overuse of antibiotics in such cases contributes to antimicrobial resistance. The appropriateness of antibiotic use must be evaluated to ensure rational prescribing and minimize unnecessary prescriptions.
OBJECTIVES
This review aims to evaluate the effectiveness and associated signs and symptoms of empiric antibiotic treatment for ≤5 days compared to >5 days in patients presenting with dental pain.
METHODS
This protocol has been conducted following PRISMA-P guidelines. A comprehensive search of four electronic databases, such as PubMed, Scopus, Cochrane and Embase was performed to find pertinent studies. This study will follow PICOS framework, including individuals receiving antibiotic treatment for oro-facial pain. Randomized controlled trials evaluating the use of empirical antibiotics for <5 days, compared to >5 days for dental pain management. Outcomes assessed will be pain reduction, quality of life improvement, adverse events related to antibiotic, clinical resolution, microbiological and radiological findings, biomarkers, antimicrobial resistance, cost implications. Independent reviewers will screen the studies, assess the risk of bias by using RoB-2 and certainty of evidence by using GRADE. Where feasible, a meta-analysis will be conducted to synthesize findings and provide a quantitative summary of the results.
RESULTS
The study commenced in February 2025 and is anticipated to be completed by May 2025.
CONCLUSIONS
This review will evaluate the effectiveness of antibiotic prescriptions for dental pain, minimizing adverse effects and identifying guideline adherence gaps. Findings will support antibiotic stewardship and inform policies to promote rational use, aiming to curb antimicrobial resistance while ensuring effective, evidence-based pain management in dental practice.
背景
牙髓和根尖周感染通常会导致牙痛和口腔内肿胀，这是急诊就诊的主要原因。在此类情况下过度使用抗生素会导致抗菌药物耐药性。必须评估抗生素使用的合理性，以确保合理开药并尽量减少不必要的处方。
目的
本综述旨在评估在出现牙痛的患者中，经验性抗生素治疗≤5天与>5天相比的有效性及相关体征和症状。
方法
本方案按照PRISMA-P指南进行。对四个电子数据库（如PubMed、Scopus、Cochrane和Embase）进行全面检索以查找相关研究。本研究将遵循PICOS框架，包括接受抗生素治疗口腔面部疼痛的个体。评估经验性抗生素使用<5天与>5天用于牙痛管理的随机对照试验。评估的结果将包括疼痛减轻、生活质量改善、与抗生素相关的不良事件、临床缓解、微生物学和放射学检查结果、生物标志物、抗菌药物耐药性、成本影响。独立评审员将筛选研究，使用RoB-2评估偏倚风险，并使用GRADE评估证据的确定性。在可行的情况下，将进行荟萃分析以综合研究结果并提供结果的定量总结。
结果
该研究于2025年2月开始，预计于2025年5月完成。
结论
本综述将评估用于牙痛的抗生素处方的有效性，尽量减少不良反应并识别指南依从性差距。研究结果将支持抗生素管理，并为促进合理使用的政策提供信息，旨在遏制抗菌药物耐药性，同时确保牙科实践中有效、基于证据的疼痛管理。
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