Antibiotic prophylaxis practices in dentistry: a survey of dentists and physicians.
BACKGROUND
A survey was conducted to determine prescribing practices of general dental and medical practitioners regarding the use of antibiotics for prophylaxis.


METHODS
A questionnaire with an accompanying letter was designed to investigate prescribing practices of general dentists and physicians. The survey encompassed demographic data, mechanisms to keep current with prophylactic practice, first- and second-line drugs prescribed with doses and directions, applicable medical conditions and dental procedures warranting antibiotic prophylaxis. Names were chosen randomly from provincial lists and ethics approval was granted. Responses were compared with 1997 American Heart Association (AHA) guidelines.


RESULTS
In all, 1,500 surveys were sent to each group, with a response rate of 32% of dentists and 17% of physicians. There was a significant difference (p < 0.05) between dentists (95%) and physicians (71%) in selecting the correct first-line antibiotic, amoxicillin, and in choosing the correct dose of amoxicillin (i.e., 2 g, 1 hour before treatment): 88% of dentists and 48% of physicians (p < 0.05). Appropriate second-line drugs were correctly selected by 84% of dentists and 67% of physicians--a significant difference (p < 0.05)--with clindamycin chosen most often (82% and 49%, respectively). Over 90% of respondents in both professions correctly identified conditions, such as prosthetic heart valve and endocarditis, requiring antibiotic prophylaxis.


CONCLUSIONS
Clinicians are not always aware of current clinical guidelines, and dentists and physicians exhibit different patterns regarding antibiotic prescribing. Dentists are more familiar than physicians with current protocols of the AHA.
Lauber
Carmen
C
carmenlauber@shaw.ca
Lalh
Saranjeev S
SS
Grace
Michael
M
Smith
Miller Hayden
MH
MacDougall
Kevin
K
West
Paul
P
Compton
Sean
S
D000572:American Heart Association; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002170:Canada; D002981:Clindamycin / Q000008:administration & dosage; D017742:Dental Care for Chronically Ill / Q000706:statistics & numerical data*; D004697:Endocarditis, Bacterial / Q000517:prevention & control*; D004917:Erythromycin / Q000008:administration & dosage; D005194:Family Practice; D005792:General Practice, Dental; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006350:Heart Valve Prosthesis; D006801:Humans; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D004917:Erythromycin; D000658:Amoxicillin