00000cam a22000003a 4500 UP-1685523046126335609 Buklod 20171215091058.0 m |o d | cr ||||||||||| 171215s xx d r |||| u| (iLib)UPMNL-00015728556 UPDent eng LG 993.5 2016 D4 A58 Antonio, Anne Margarette S. Knowledge and practice of prescribing oral antibiotics of dental practitioners in the City of Manila a descriptive study Anne Margarette S. Antonio... [et al.]. 117 leaves. Seminar Paper--Doctor of Dental Medicine--University of the Philippines Manila. INTRODUCTION: The emergence of antibiotic resistance has been a worldwide concern and an increasingly serious threat to the public nowadays. Among the key factors identified that contribute to antibiotic resistance are the overuse and misuse of antibiotics, and healthcare providers play a major role in this emergence (WHO, 2014). In the dental profession, antibiotics are used as therapeutic and prophylactic agents when managing a number of oral infections and preventing serious systemic spread of infections. The purpose of this study is to determine the knowledge and practice of oral antibiotic prescribing of private dental practitioners in the City of Manila. Moreover, this study aims to determine the common antibiotics they prescribe, the factors affecting their choice of antibiotic regimen, and their knowledge on the appropriate dosage, frequency, duration, indications of certain antibiotics, and the clinical conditions to which they are prescribed. METHODS: Self-administered questionnaires with consent were distributed personally among private dental practitioners whose clinics are located in the City of Manila. The questionnaire was pre-tested prior to actual data collection and feedbacks for improvement were adjusted accordingly. The questionnaires aimed to collect information regarding their antibiotic prescribing practices and knowledge, along with certain demographic surveys. A total of 225 copies of the questionnaires were distributed from which 203 practitioners gave consent to participate in the study, with sample representatives from each of the six districts of Manila. Descriptive statistics was used to establish trends on each question and corresponding answers. RESULTS: For prophylactic prescribing practices of the participants, a great majority of the participants correctly prescribe for patients when doing extraction (97.2%), soft tissue surgery (78.65%), root canal treatment (65.73%), scaling and polishing (62.92%) and dental implant (39.32%). However, it is important to note that antibiotic prescription for patients when doing restoration (21.35%), orthodontics (15.73%), and denture service (10.11%) is not warranted. It can also be observed that the participants correctly prescribe for patients with Human Immunodeficiency Virus/AIDS (53.18%), Diabetes Mellitus (71.1%), autoimmune disease (53.18%), and those taking immunosuppressive drugs, (49.13%). However, prescribing for patients with the previously mentioned conditions when doing certain dental procedures for which they are not indicated is also observed in our study. These procedures are restoration, orthodontic treatment, and denture service. Furthermore, a considerable number of the participants would inappropriately prescribe antibiotics for patients with hepatitis (38.73%), hypertension (51.45%), hyperthyroidism (35.26%), myocardial infarction (61.27%), rheumatic heart disease (79.77%), and previous cardiovascular disease (66.47%). The figures stated above are for extraction procedure which was the participants? primary answer for all the medical conditions stated. Majority of the participants correctly prescribe antibiotics when signs or symptoms like board-like swelling (70.15%), gross diffuse swelling (51.74%), closure of the eye because of swelling (68.16%) and elevated temperature (50.75%) are present. However, only about 20-27% consider malaise and restricted mouth opening when these are also signs of systemic spread of infection. A substantial number of participants (31.2%) consider patient preference as a factor in choosing the antibiotic regimen to be prescribed when this should not be one. Amoxicillin was the most frequently prescribed first-line antibiotic 78.8% while clindamycin was the most common alternative antibiotic prescribed in case the patient is allergic to the first-line antibiotic (52.3%). Significant number of participants answered the recommended dosage for both amoxicillin and clindamycin, but the frequency of intake varies differently in both antibiotic. An alarming rate of the participants (90.15%) would prescribe antibiotics for conditions of acute apical abscess in which most cases are localized and would respond to mere local measures like root canal treatment or extraction. A considerable number of participants would also prescribe antibiotics to other conditions which they are not indicated like chronic periapical abscess (68.97%), apical periodontitis (47.78%), and pulpitis (44.33%). A minority, but still a cause for alarm, of the participants would also prescribe for cases of dental caries (6.40%), gingivitis (21.67%), mild chronic periodontitis (25.62%), and asymptomatic impacted tooth (23.65%) which is unnecessary. More than half of the participants (57.64%) would correctly prescribe antibiotic for cases of cellulitis, but only about 40% would prescribe for aggressive and severe chronic periodontitis. CONCLUSION: Based on the established literature and guidelines cited in this study, the results show that the standard adult prescription was correctly prescribed by majority of the participants for amoxicillin only, while lesser percentage correctly answered for other antibiotics. Also, antibiotic is appropriately prescribed by majority for severe infection like cellulitis, but unnecessarily given for other conditions like chronic and acute apical abscess, apical periodontitis, pulpitis, and gingivitis. The most commonly prescribed antibiotic is amoxicillin, while the alternative drug of choice by the majority is clindamycin. The prophylactic antibiotic practice of the participants varies widely on different dental procedures and medical conditions of the patient, but the results show that a great percentage of the participants prescribe unnecessarily for patients with medical conditions who are not at risk, like hypertension, hyperthyroidism, rheumatic heart disease, and others. In choosing the antibiotic regimen, most of the participants answered effectivess and previous experience of the drug as a major factor to consider. The results of the study can be generalized and extrapolated to the target population, City of Manila, since the participants were representatives of each of the congressional districts of Manila. The sampling design utilized ensured that each congressional district of Manila is well-represented in the study. Antibiotics in dentistry. Oral infection. Biascan, Josher N. de Peralta, Alud Stella A. Karganilla-Frange, Melanie Ruth, Faculty co-author. Pacete-Estrera, Kristine Rachelle, (Adviser). UPMNL DENT LG 993.5 2016 D4 A58 Book