Pattern of antibiotic prescription in the management of endodontic infections amongst Spanish oral surgeons.
OBJECTIVE
To identify antibiotic prescription practices in the treatment of endodontic infections amongst Spanish oral surgeons.


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 with 127 returned (64%).


RESULTS
The average duration of antibiotic therapy was 7.0 +/- 1.0 days. Ninety five percent of respondents selected amoxicillin as the first choice antibiotic in patients with no medical allergies, alone (34%) or associated to clavulanate (61%). The first drug of choice for patients with an allergy to penicillins was clindamycin 300 mg (65%), followed by azithromycin (15%) and metronidazole-spiramycin (13%). For cases of irreversible pulpitis, 86% of respondents prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis and no swelling, 71% prescribed antibiotics. Almost 60% of respondents prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract; in this clinical situation, odontologists prescribed more frequently antibiotics compared to stomatologists (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.
Segura-Egea
J J
JJ
Department of Endodontics, School of Dentistry, University of Seville, Seville, Spain. segurajj@us.es
Velasco-Ortega
E
E
Torres-Lagares
D
D
Velasco-Ponferrada
M C
MC
Monsalve-Guil
L
L
Llamas-Carreras
J M
JM
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003790:Dental Pulp Necrosis / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000188:drug therapy; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D011671:Pulpitis / Q000188:drug therapy*; D013030:Spain; D013515:Surgery, Oral; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents