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. 2024 Nov 26;13(12):1135.
doi: 10.3390/antibiotics13121135.

Dental Antimicrobial Stewardship: Developing a Mobile Application for Rational Antibiotic Prescribing to Tackle Misdiagnosis

Jelena Roganović  1 , Stefan Djordjević  2 , Milena Barać  1 , Jasna Crnjanski  3 , Ivana Milanović  4 , Jugoslav Ilić  4
Affiliations

Dental Antimicrobial Stewardship: Developing a Mobile Application for Rational Antibiotic Prescribing to Tackle Misdiagnosis

Jelena Roganović et al. Antibiotics (Basel). .

Abstract

Background/objectives: Inexperienced dentists and dental students are especially prone to misdiagnosis, and this represents a huge problem regarding antimicrobial stewardship. We aimed to develop a mobile app for rational antibiotic prescribing in dentistry based on local-systemic symptoms and patient factors, rather than solely on diagnosis, to tackle misdiagnosis.

Methods: The study involved 64 participants, 50 of which were third-year dental students attending a pharmacology course focusing on antimicrobials, comprising lectures and practical sessions without (noAPP group, n = 22) or with (APP group n = 28) the assistance of a mobile application. The other 14 participants were practicing dentists who decided to register and use the application. All registered users of the application were asked to take a feedback survey, while learning outcomes were evaluated via a pharmacology quiz.

Results: A decision tree was used for application development. In total, 76 impressions were collected on the application. The majority of the impressions were related to odontogenic-endodontic infections. Multiple linear regression analysis did not reveal differences in survey responses between practicing dentists and undergraduate students in the feedback survey responses. There was a significant difference in the mean pharmacology test scores between the noAPP and APP groups (5.50 ± 1.80 vs. 7.21 ± 1.03, p = 0.0001).

Conclusions: The dentalantibiotic.com application was developed to support rational antibiotic prescribing, in view of tackling misdiagnosis, among inexperienced dentists, as well as to assist in undergraduates' pharmacology learning, and the current study shows its large impact as an educational tool. The majority of participants considered it easy to use, efficient in facilitating the right antibiotic choice, and useful for everyday decision-making.

Keywords: antimicrobial stewardship; dentistry; misdiagnosis; mobile application.

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Conflict of interest statement

Author Stefan Djordjević was employed by IMP-Computer Systems Ltd. (IMP-CS). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The decision tree (A) and the graphical interface of the application (https://www.dentalantibiotic.com/protocol; accessed on 4 November 2024) (B).
Figure 2
Figure 2
Distribution of responses to survey questions (A), as well as pharmacology test scores (B), and frequency of students with correct answers on proper pharmacological treatment of pulpal and periapical pain and swelling, endocarditis prophylaxis, antibiotic use in pregnancy, and antibiotic prescription-related patient factors (C) among students who used the application (APP group) and those who did not use the application (noAPP group).
See this image and copyright information in PMC

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