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

立陶宛牙医使用抗生素治疗和预防牙源性感染的横断面调查

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Abstract

Background and Objectives: 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. Materials and Methods: 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. Results: 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, p = 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, p = 0.021). Conclusions: 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.

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