Antibiotic prescription patterns for treating dental infections in children among general and pediatric dentists in teaching institutions of Karachi, Pakistan
Authors: Sadaf Ahsan, Muhammad Zafar Iqbal Hydrie, Syed Muhammad Zulfiqar Hyder Naqvi, Munir Ahmed Shaikh, Muhammad Zahid Shah, Syed Imtiaz Ahmed Jafry
Journal: PLoS One (2020)
MeSH terms: Anti-Bacterial Agents / therapeutic use, Dentists / psychology, Drug Prescriptions / statistics & numerical data, Practice Patterns, Dentists' / statistics & numerical data, Tooth Diseases / drug therapy, Adult, Child, Child, Preschool, Cross-Sectional Studies, Female, Guideline Adherence, Humans, Infant, Interviews as Topic, Male, Pakistan, Pediatric Dentistry, Surveys and Questionnaires, Tooth Diseases / microbiology, Young Adult, Anti-Bacterial Agents

Background:
Antibiotics are regularly prescribed by dental professionals in their practice, for the purpose of dental treatment as well as for the prevention of infection. The inappropriate use of antibiotics is a significant factor in the rise of antibiotic resistance. There is an immediate need for the advancement of prescribing guidelines and instructive polices to encourage the rational and appropriate utilization of medications especially antibiotics in dentistry.
Objective:
The aim of this study was to identify the frequency of antibiotic prescription for treating dental infections in children among dentists in teaching institutions of Karachi, Pakistan and whether they are adhering to the prescribed international guidelines.
Methods:
A cross-sectional study was conducted in three private and two public colleges of Karachi. After taking written informed consent and checking the inclusion criteria, a total of 380 participants were interviewed using a pre-designed validated questionnaire which included demographic profile and clinical case scenarios. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using chi-square test. The significance level was set at 0.05.
Results:
Of the 380 subjects, a majority (71.3%) treated 15 or less children per month (n = 271) while 28.7% of dentists (n = 109) treated more than 15 children per month. Overall adherence to American Academy of Pediatric Dentistry guidelines was low from 26.1% to 44.2%. The difference between adherence of dentists with low and high volume of pediatric patients was significantly different for case scenarios 1, 3, 4 and 5 (p<0.001 for all) where dentists who treated 15 or less children per month were more likely to be adherent to standard antibiotic prescription guidelines than those who treated more than 15 children per month.
Conclusions:
This study shows that majority of dentists, particularly dentists with high volume of pediatric patients lacked adherence to professional guidelines for prescribing antibiotics for treating dental infection in children. There seem to be a lack of harmony between the recommended professional guidelines and the antibiotic prescribing pattern of dentists. Regular updates and continuing medical education for the health professionals regarding comprehensible and specific professional guidelines may lead to improved adherence of antibiotics prescription amongst dentists.