Antibiotic Prescribing for Endodontic Infections and Prophylaxis for Medically Compromised Patients: A Survey on Dental Students in Turkey

Introduction: High and wrong antibiotic usage causes Antimicrobial Resistance (AMR) which is a worldwide problem. Dental students, as future dentists are likely to provoke this public health issue by inappropriate prescribing choices. There is a need of further education of antibiotic prescription in endodontic infections, as well as prophylaxis. Aim: The aim of this study was to establish the knowledge of dental students on the suitable use of systemic antibiotics for endodontic infections and prophylaxis for medically compromised patients. Materials and Methods: A survey was done on dental students at the end of third, fourth and fifth years, who answered a questionnaire about antibiotic use for endodontic infections and prophylaxis for various immunocompromised patients. Pharmacology and endodontics lectures should be taken by respondents; was the inclusion criterion. Data were analysed using descriptive statistics and Chi-square test. Statistical significicance was fixed at p<0.05. Results: Amoxicillin + clavulanic acid (500/125 mg) was the first-choice antibiotic of students. The percentage of fifth grade students who would prescribe amoxicillin + clavulanic acid (500 mg/125 mg) was lower than third and fourth grade students (p=0.006). In case of allergy to penicillin, clindamycin 300 mg was selected as a first-choice antibiotic by 78.3% of students. About 50.2% of the respondents indicated a treatment duration of 3-7 days, while 28.5% chose more than seven days usage. Fourth grade dental students who would prescribe antibiotics for more than seven days (40.7%) were found to be statistically more significant than third (27.8%) and fifth (16%) grade students (p=0.004). In case of acute apical abscess with systemic manifestations, 94.5%, which is the highest percentage of all, of students would prescribe antibiotic. Third grade dental students were the most antibiotic prescribing group for chronic apical periodontitis and periradicular (pocket) cyst (p=0.000). Patients with history or risk of bacterial endocarditis, were prescribed prophylactive antibiotics at a rate of 92.3% by students. Conclusion: Even though the results showed acceptable levels of competence, dental education should place greater focus on prescription of antibiotics to prevent Antimicrobial Resistance (AMR).