title: Trends in antibiotic use and microbial diagnostics in periodontal treatment: comparing surveys of German dentists in a ten-year period.
abstract: OBJECTIVE
  The use of antibiotics and microbial tests in periodontal treatment among German dental practitioners was investigated in 2012-2013 and compared with 2002-2003 data.
  
  
  METHODS
  One thousand four hundred representative German practitioners received a postal questionnaire requesting their prescribing habits concerning type, dose, frequency, and sequence of antibiotics adjunctive to mechanical debridement. Additionally, the use of local antimicrobials and microbial tests were recorded.
  
  
  RESULTS
  The response rate was 29.1 % (407 reports). Drug combinations, especially amoxicillin plus metronidazole, were prescribed most frequently (32.8 %) with an increase of 7.4 % during the past decade, followed by clindamycin (29.3 %). Amoxicillin monotherapy was used unexpectedly frequently (17.0 %) and doxycycline (2.8 %) very infrequently. Then, 24.7 % prescribed antibiotics prior to mechanical therapy, while most dentists followed the recommended sequence. The use of local antimicrobials increased by 6.2 % and of microbial diagnostics by 20.8 %.
  
  
  CONCLUSIONS
  Positive trends regarding position-paper-conform prescribing habits including the scheduling of systemic antibiotics and increasing use of local antimicrobials and microbial tests were observed. However, deficits and malpractice still exist in German practices. Unexpected is the widespread and increasing use of clindamycin. Continuing educational campaigns and strictly expressed real guidelines are needed.
  
  
  CONCLUSIONS
  Indication and choice of antibiotic agents in causal periodontal therapy among German dentists have changed between 2003 and 2013 toward a more position-paper-based concept, but inappropriate prescriptions of second choice antibiotics still remain conspicuous.
authors.affiliation: Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Pauwelsstrasse 30, D-52074, Aachen, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Falkenstein
authors.affiliation: Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany.
authors.forename: Jamal M
authors.initials: JM
authors.lastname: Stein
authors.affiliation: Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Pauwelsstrasse 30, D-52074, Aachen, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Henne
authors.affiliation: Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Pauwelsstrasse 30, D-52074, Aachen, Germany. gconrads@ukaachen.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Conrads
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003646:Debridement; D005858:Germany; D006801:Humans; D010510:Periodontal Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial agents; Dental practice; Diagnostic tests; Periodontal treatment; Survey