Knowledge and Behavior of a Group of Dentists towards Antibiotic Prescription to Pediatric Patients in Baghdad.

Authors

  • Zaid Naji Muhson Specialist dentist in Preventive Dentistry (M.Sc.). Iraqi Ministry of Health/ Specialized Center of Preventive and Pediatric Dentistry/Al-Resafa / Baghdad
  • Wesal Ali Al-Obaidi Professor in Preventive Dentistry (M.Sc.). Ibn Sina University/College of Dentistry

DOI:

https://doi.org/10.32828/mdj.v19i1.990

Abstract

Aim:  To evaluate the knowledge and behavior of a group of dentists in Baghdad towards prescribing antibiotics to pediatric patients.

Method: A Cross sectional study was conducted by an electronic self- administered questionnaire to dentists specialized in Preventive or Pediatric Dentistry, general dentists with certificate in Preventive and Pediatric and Preventive Dentistry and to general dentists working in health centers of Al-Resafa in Baghdad. Open-ended and closed-ended questions were directed to the dentists regarding the knowledge and behavior towards prescribing antibiotics to children.

Results: (116) dentists responded to the questionnaire consisted of (36) specialized dentists in Pediatric or Preventive dentistry, (8) general dentists (certificate in Preventive and pediatric Dentistry) and to (72) general dentist. Most of the dentists with an age range from 21 to 30. Females constituted most of the sample (74.1%). General dentists represented the higher proportion (62.1%). Only (38.8%) of the dentists were self-educated whereas the medical websites seemed to be the main source (80.0%). Besides, only (13.8%) of total dentists have attended scientific medical course on antibiotics indications and/or resistance for the last two years. Amoxicillin was the main antibiotic prescribed for non-allergic children (75.9%), whereas Erythromycin and Azithromycin were prescribed for allergic children (73.3%). (42.2 %) of the sample prescribed antibiotics once per-week, while (13.8%) prescribed on need.

 

 Cellulitis contributed (60.3%) among conditions need prescription of antibiotics before and/or after the treatment. Regarding the prophylactic antibiotics, high risk cardiac conditions represented (93.1%).

Conclusion: Most of the general and specialist dentists were aware towards antibiotics prescription for children but lacked in updating their information which based primarily on their previous dental education.

References

Machuca M, Espejo, Gutierrez L, Herrera J. Análisis de la prescripción antibiótica en una farmacia comunitaria. Pharm Care Esp 2000;18:300-7.

Steven Schwartz, DDS. Commonly Prescribed Medications in Pediatric Dentistry Crest® Oral-B® at dentalcare.com Continuing Education Course, Revised January 8, 2016 [Google Scholar].

Alaluusua S1, Veerkamp J2, Declerck D3. Policy document for the use of Antibiotics in Paediatric Dentistry (2002). European Academy of Paediatric Dentistry (EAPD). P. 2.

https://www.eapd.eu/uploads/20A87CB2_file.pdf

Vasudavan S, Grunes B, Mcgeachie J, Sonis AL. Antibiotic prescribing patterns among dental professionals in Massachusetts. Pediatr Dent 2019;41:25-30. https://www.ingentaconnect.com/content/aapd/pd/2019/00000041/00000001/art00003;jsessionid=2i2m2pph9hbkw.x-ic-live-02

Haque M, Sartelli M, Haque SZ. Dental infection and resistance—global health consequences. Dent J (Basel) 2019;7:22. https://www.mdpi.com/2304-6767/7/1/22

Inchara R, Ganapathy D, Kumar PK. Preference of antibiotics in pediatric dentistry. Drug Invent Today 2019;11:1495-98. https://www.researchgate.net/profile/Kiran-Pandurangan/publication/335442303_Preference_of_antibiotics_in_pediatric_dentistry/links/5d6601e1299bf1f70b124964/Preference-of-antibiotics-in-pediatric-dentistry.pdf

Pinkham JR. Pediatric Dentistry: Infancy through Adolescence. 4th ed. St Louis, Mo: Elsevier Saunders; 2005. [Google Scholar].

Metlay JP, Stafford RS, Singer DE. National trends in the use of antibiotics by primary care physicians for adult patients with cough. Arch Intern Med. 1998;158:1813–8. pmid:9738612. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/209004

McManus P, Hammond ML, Whicker SD, Primrose JG, Mant A, Fairall SR. Antibi-otic use in the Australian community, 1990–1995. Med J Aust. 1997;167:124–7. pmid:9269265. https://onlinelibrary.wiley.com/doi/abs/10.5694/j.1326-5377.1997.tb138809.x

Hurley S, Westgarth D. When David met Sara Part 2. Br Dent J. 2015 Nov 27;219(10):477. pmid:26611300. https://www.nature.com/articles/sj.bdj.2015.880

Dar-Odeh NS, Abu-Hammad OA, Al-Omiri MK, Khraisat AS, Shehabi AA. Antibiotic prescribing practices by dentists: a review. Ther Clin Risk Manag. 2010;21:301–6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909496/

Ready D, Bedi R, Spratt DA, Mullany P, Wilson M. Prevalence, proportions, and identities of antibiotic-resistant bacteria in the oral microflora of healthy children. Microb Drug Resist. 2003 Dec 1;9(4):367–72. pmid:15000743. https://www.liebertpub.com/doi/10.1089/107662903322762806?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed

Abu-zineh R, Dar-Odeh N, Shehabi A. Macrolide resistance genes and virulence factors of common viridans Streptococci species colonizing oral cavities of patients in Jordan. Oral Health Dent Manag. 2015;14:337–41. https://www.researchgate.net/publication/284442697_Macrolide_Resistance_Genes_and_Virulence_Factors_of_Common_Viridans_Streptococci_Species_Colonizing_Oral_Cavities_of_Patients_in_Jordan

Ahsan S, Hydrie MZI, Naqvi SMZH, Shaikh MA, Shah MZ, Jafry SIA. Antibiotic prescription patterns for treating dental infections in children among general and pediatric dentists in teaching institutions of Karachi, Pakistan. PLoS ONE. 2020;15(7 July):1–11. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235671

Aidasani B, Solankis M, Khetarpal S, Ravi PS. Antibiotics: their use and misuse in paediatric dentistry. A systematic review. Eur J Paediatr Dent. 2019;20(2):133–8. file:///C:/Users/spn/Downloads/Documents/EJPD_2019_20_2_10_2.pdf

Teoh L, Stewart K, Marino R, McCullough M. Antibiotic resistance and relevance to general dental practice in Australia. Aust Dent J. 2018;63(4):414–21. https://onlinelibrary.wiley.com/doi/10.1111/adj.12643

Lewis MAO. Why we must reduce dental prescription of antibiotics: European Union Antibiotic Awareness Day. Br Dent J.2008;205(10):537-8. https://doi.org/10.1038/sj.bdj.2008.984

Palmer NO. Antibiotic prescribing in general dental practice. Prim Dent J 2014; 3(1): 52-7. https://doi.org/10.1308/205016814812135878

Fine DH, Hammond BF, Loesche WJ.Clinical use of antibiotics in dental practice. Int J Antimicrob Agents 1998; 9(4): 235-238. https://www.sciencedirect.com/science/article/abs/pii/S092485799800003X?via%3Dihub

Aly MM, Elchaghaby MA. The prescription pattern and awareness about antibiotic prophylaxis and resistance among a group of Egyptian pediatric and general dentists: a cross sectional study. BMC Oral Health. 2021; 21: 322. https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-021-01685-y

Konde S, Jairam LS, Peethambar P, Noojady SR, Kumar NC. Antibiotic overusage and resistance: a cross-sectional survey among pediatric dentists. J Indian Soc Pedod Prev Dent. 2016;34(2):145–151. doi: 10.4103/0970-4388.180444. https://www.jisppd.com/article.asp?issn=0970-4388;year=2016;volume=34;issue=2;spage=145;epage=151;aulast=Konde

Rubanenko M, Blumer S, Maalof K, Elbahary S, Katz L, Kharouba J. Assessment of the Knowledge and Approach of General Dentists Who Treat Children and Pediatric Dentists Regarding the Proper Use of Antibiotics for Children. Antibiotics (Basel). 2021 Sep 28;10(10):1181. https://doi.org/10.3390/antibiotics10101181

Paude G, Shah AK, Palikhey A, Khanal N, Karki S, Chaurasia L, Chaulagain R. Knowledge, attitude and practice of prescribing antibiotics among dental practitioners in Chitwan. Europasian J Med Sci. April 2021;3(1):66-72. https://doi.org/10.46405/ejms.v3i1.171

Huttner A, Bielicki J, Clements MN, Frimodt-Moller N, Muller AE, Paccaud JP et al. Oral amoxicillin and amoxicillin-clavulanic acid: properties, indications and usage. Clin Microbiol Infect. 2020; 26(7): 871-879. https://doi.org/10.1016/j.cmi.2019.11.028.

Al-Johani K, Reddy SG, Al Mushayt AS, El-Housseiny A. Pattern of prescription of antibiotics among dental practitioners in Jeddah, KSA: A cross-sectional survey. Niger J Clin Pract. 2017 Jul;20(7):804-810. doi: 10.4103/1119-3077.196072. PMID: 28791973. https://www.njcponline.com/text.asp?2017/20/7/804/196072.

D'Ambrosio F, Di Spirito F, Amato A, Caggiano M, Lo Giudice R, Martina S. Attitudes towards Antibiotic Prescription and Antimicrobial Resistance Awareness among Italian Dentists: What Are the Milestones? Healthcare (Basel). 2022 Aug 21;10(8):1585. doi: 10.3390/healthcare10081585. PMID: 36011242; PMCID: PMC9408165. https://doi.org/10.3390/healthcare10081585

Nishimura, R.A.; Otto, C.M.; Bonow, R.O.; Carabello, B.A.; Erwin, J.P., 3rd; Fleisher, L.A.; Jneid, H.; Mack, M.J.; McLeod, C.J.; O’Gara, P.T.; et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017, 135, e1159–e1195.

Di Spirito, F.; Scelza, G.; Fornara, R.; Giordano, F.; Rosa, D.; Amato, A. Post-operative endodontic pain management: An overview of systematic reviews on post-operatively administered oral medications and integrated evidence-based clinical Montalti, M.; Soldà, G.; Capodici, A.; Di Valerio, Z.; Gribaudo, G.; La Fauci, G.; Salussolia, A.; Scognamiglio, F.; Zannoner, A.; https://www.ahajournals.org/doi/10.1161/CIR.0000000000000503?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

Ramadan A, Al Rikaby O, Abu-Hammad O, Dar-Odeh N. Knowledge and Attitudes Towards Antibiotic Prescribing AmongDentists in Sudan. Pesqui. Bras. Odontopediatria Clín. Integr. 2019;19:e4430. https://doi.org/10.4034/PBOCI.2019.191.17

Gori, D. Antimicrobial Resistance (AMR) in Italy over the Past Five Years: A Systematic Review. Biologics 2022, 2, 151–164. [CrossRef] recommendations.Healthcare 2022, 10, 760. https://doi.org/10.3390/biologics2020012

National Institute for Health and Clinical Excellence. Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. Available at: https://www.nice.org.uk/guidance/cg64 [Accessed on January 9, 2018].» https://www.nice.org.uk/guidance/cg64

Lockhart PB, Tampi MP, Abt E, Aminoshariae A, Durkin MJ, Fouad AF, Gopal P, Hatten BW, Kennedy E, Lang MS, Patton LL, Paumier T, Suda KJ, Pilcher L, Urquhart O, O'Brien KK, Carrasco-Labra A. Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association. J Am Dent Assoc. 2019 Nov;150(11):906-921.e12. doi: 10.1016/j.adaj.2019.08.020. PMID: 31668170; PMCID: PMC8270006. https://doi.org/10.1016/j.adaj.2019.08.020

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Published

28.06.2023

How to Cite

Naji Muhson, Z. ., & Ali Al-Obaidi, W. . (2023). Knowledge and Behavior of a Group of Dentists towards Antibiotic Prescription to Pediatric Patients in Baghdad. Mustansiria Dental Journal, 19(1), 29–43. https://doi.org/10.32828/mdj.v19i1.990