Antibiotic prophylaxis in oral health care: administration strategies of general dental practitioners.
OBJECTIVE
To examine the strategies that general dental practitioners (GDPs) use to administer antibiotic prophylaxis and to study the agreement between the administration strategies of GDPs and local recommendations.


METHODS
Postal questionnaires in combination with telephone interviews were used. Two hundred GDPs in two Swedish counties, Skåne and Orebro, were asked to participate. The response rate was 51% (n = 101). The GDPs were presented with eight simulated cases of patients with different medical conditions for which antibiotic prophylaxis might be considered necessary when performing dental procedures (scaling, tooth removal, root canal treatment). The administration strategies of the GDPs were compared with local recommendations.


RESULTS
In general, the variation in the administration strategies of the GDPs was large. For two medical conditions, type 1 diabetes that was not well controlled and hip prosthesis, significantly more GDPs in Skåne than in Orebro administered antibiotic prophylaxis for tooth removal. Agreement between the administration strategies of the GDPs and local recommendations was low. Differences between the two counties were non-significant. Furthermore, within Orebro, GDPs who did not have formal access to local recommendations did not differ in their administration strategies from those who did. The choice of substance was seldom in agreement with the substance recommended, while the majority followed the recommended duration of treatment.


CONCLUSIONS
Although recommendations existed, their impact appeared to be limited. This is significant, since the implementation of recommendations is crucial in making clinical practice more effective and in promoting the health of patients.
Ellervall
Eva
E
Faculty of Odontology, Malmö University, Malmö, Sweden.
Björklund
Fredrik
F
Rohlin
Madeleine
M
Vinge
Ellen
E
Knutsson
Kerstin
K
D000328:Adult; D019072:Antibiotic Prophylaxis / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D017742:Dental Care for Chronically Ill / Q000379:methods* / Q000592:standards; D012534:Dental Scaling / Q000379:methods; D003920:Diabetes Mellitus; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019239:Practice Patterns, Dentists'; D012390:Root Canal Therapy / Q000379:methods; D011795:Surveys and Questionnaires; D013548:Sweden; D014081:Tooth Extraction / Q000379:methods