Pattern of antibiotic prescription in the management of endodontic infections amongst Spanish oral surgeons

Abstract

Introduction. The purpose of this study was to identify antibiotic prescription practices in the treatment of endodontic infections among Spanish dentists with preferential dedication to Oral Surgery. Methods. Members of the Spanish Oral Surgery Society (SECIB) were surveyed on antibiotic prescription on six different pulpal and periapical diagnoses. A total of 200 questionnaires were delivered to the assistants but only 127 were returned properly answered (63.5%). Results. The average duration of antibiotic therapy was 7.0  1.0 days. Ninety five percent of respondents selected amoxicillin as first-choice antibiotic in patients with no medical allergies, alone (33.9%) or associated to clavulanate (60.6%). The first drug of choice for patients with an allergy to penicillins was clindamycin 300 mg (65.4%), followed by azithromicyn (15.0%) and metronidazole-spiramycin (13.4%). For cases of irreversible pulpitis, 85.8 % of respondents prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis, and no swelling, 70.9% prescribed antibiotics. Almost 60% of respondents prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract; in this clinical situation DDS prescribed more frequently antibiotics compared to MD (p = 0.0080; odds ratio = 8.0; C. I. 95% = 1.7 – 37.1). Conclusions. The majority of the members of the SECIB were selecting the appropriate antibiotic for use in endodontic infections, but there are still many who are prescribing antibiotics inappropriately. The use of antibiotics for minor infections, or in some cases in patients without infections, could be a major contributor to the world problem of antimicrobial resistance.