Use of antibiotics by spanish dentists receiving postgraduate training in endodontics

Abstract

Background: The incidence of endodontic infections is high. The contribution of Endodontics to the global problem of antibiotic resistance could be significant. The ESE, together with the World Health Organization, are promoting the World Antibiotic Awareness Week (13-19 November 2017) to promote the appropriate use of systemic antibiotics in Endodontics. The objective of this study was to determine the prescription pattern of antibiotics in the treatment of endodontic infections of Spanish dentists attending specialization programs in Endodontics.

Material and methods: Dentists from five Spanish endodontic postgraduate programs were requested to answer a one-page questionnaire surveying about antibiotics indications. Seventy-three dentists were required to participate in this investigation, and 67 (91.2%) fulfilled satisfactorily the survey and were included in the study. Data were analyzed using descriptive statistics and chi square test.

Results: The average duration of antibiotic therapy was 6.8±1.2 days. All respondents chose amoxicillin as first choice antibiotic in patients with no medical allergies, alone (40%) or associated to clavulanic acid (60%). The first drug of choice for penicillin allergic patients was clindamycin (72%). For cases of irreversible pulpitis, 22% of respondents prescribed antibiotics. For the scenario of a necrotic pulp, symptomatic apical periodontitis and no swelling, 37% prescribed antibiotics. A quarter of dentists prescribed antibiotics for necrotic pulps with asymptomatic apical periodontitis and a sinus tract.

Conclusions: The results of this study show that postgraduate training in Endodontics provides greater awareness of the correct indications of antibiotics. Dentists who have received specialized training in Endodontics have a prescription pattern of antibiotics more adjusted to the guidelines recommended by international organizations and by scientific societies. Key words:Antibiotics, apical periodontitis, dental curriculum, endodontic infections, postgraduate endodontic training.

Figure 1

Antibiotic survey.

Figure 2

Top. Distribution of respondents by treatment duration (p> 0.05). Bottom. Percentages of respondents of each endodontic program who prescribe antibiotics in the different clinical situations: 1) Irreversible pulpitis with moderate/severe symptoms. 2) Irreversible pulpitis with symptomatic apical periodontitis and moderate/severe symptoms. 3) Necrotic pulp with asymptomatic apical periodontitis, no swelling, and no or mild symptoms. 4) Necrotic pulp with symptomatic apical periodontitis, no swelling, and moderate/severe symptoms. 5) Necrotic pulp with asymptomatic apical periodontitis, sinus tracts and no/mild symptoms. 6) Necrotic pulp with symptomatic apical periodontitis, swelling, and moderate to severe symptoms. * p< 0.05.