KNOWLEDGE AND PATTERNS OF ANTIBIOTIC PRESCRIPTION AMONG DENTAL PRACTITIONERS IN HAIL , SAUDI ARABIA

Table 4 . Preferred antibiotics for selected clinical conditions by dental practitioners

in terms of swelling , trismus or fever outcomes , the authors thought a small percentage may be benefited from antibiotics . However , antibiotics are encouraged for patients undergoing contaminated , long-duration surgery . 37 Etiology of alveolar osteitis , also known as dry socket , is multifactorial in origin and its incidence is low . 38 , 39 Nearly 49 % of the respondents would prescribe antibiotics to patients suffering from dry socket . There is no sound evidence to support the notion that dry socket is a complication caused by infection , therefore , antibiotics are of no value in curing the condition . 40 A quite sensible percentage ( 56.4 %) of dental practitioners would prescribe antibiotics for replantation of teeth . Systemic use of antibiotics for such conditions has been questioned and the clinical studies do not recommend such regime , as no value was achieved . Nevertheless , immersing the avulsed teeth in antibiotic solution , such as tetracycline has been advocated . Experimental studies however , revealed some positive benefits and this is the reason behind its current recommendation by the scholars of dental

41 , 42

traumatology . The most worrying malpractice is the unjustified overuse of antibiotics in conditions related to pulp pathology . The only therapy needed for these cases is local clinical intervention . In periodontal conditions , except those associated with abscess , most of the cases require local management . A percentage like 52 % of the respondents who are motivated to prescribe antibiotics for chronic periodontitis cannot be underestimated . On the other hand , consideration of antibiotic therapy for pericoronitis by 68.3 % is acceptable . Nonetheless , mild to moderate pericoronitis without signs of spread can be treated effectively by normal saline irrigation avoiding systemic antibiotic therapy . Necrotizing ulcerative gingivitis is caused by anaerobic microorganisms and warrants specific antibiotic therapy . About 64.4 % of the dental practitioners would prescribe antibiotics treatment of such conditions , though the management should emphasize on local debridement and antimicrobial mouth rinses , and systemic

Stomatology Edu Journal antibiotics should be reserved for cases associated with signs and symptoms of infection spread . Antibiotic therapy for odontogenic sinusitis was considered by 67 % of the dental practitioners . Because of the vicinity of upper apices of posterior teeth to the floor of maxillary sinus , there is no doubt of potential odontogenic infection spread . However , diagnosis of such cases needs to be meticulous to avoid unnecessary or overuse of antibiotics . Cellulitis is a serious acute condition and warrants systemic antibiotic . As nearly as 90 % of dental practitioners would prescribe systemic antibiotics to avoid further complications . Trismus is the hallmark of a masticatory space infection or infection in the anterior compartment of lateral pharyngeal space and about 41 % of the respondents opted to prescribe antibiotics . Both cellulitis and sever trismus are considered as serious medical conditions , therefore , proper diagnosis and management including referrals are crucial . On the other hand , it is very painful to see a considerable percentage ( 34.7 %) of the surveyed dental surgeons would still prescribe antibiotics for normal extraction , acute periapical infection ( 57.4 %) and for acute pulpitis ( 38.6 %). These conditions need immediate intervention rather than systemic antibiotic therapy . Many dental surgeons believe that antibiotics reduces acute pulpal pain . Nevertheless , there is insufficient evidence to support this concept . 43 Use of antibiotics for various apical pathology are still high and would be considered by more than 60 % of the respondents . The available evidence does not provide clinicians with reliable and proper guidelines for treating periapical lesions , 44 therefore , use of antibiotics in such conditions is questionable . Unfortunately , many dental practitioners would still prescribe antibiotics for simple dental procedures ;, such as restorative treatment , pulp capping , scaling and polishing , and the current percentages are higher compared to those reported by Alkhabuli et al . 22 When a question regarding antibiotic preference