Antibiotic Misuse in Endodontics by Sudanese Dentists
Antibiotic Misuse in Endodontics by Sudanese Dentists
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Date
2015-03-31
Authors
Rania Mohamed Daak
Journal Title
Journal ISSN
Volume Title
Publisher
University of Khartoum
Abstract
Background: Evidence from many studies suggests that antibiotics are
being prescribed inappropriately within general dental practice. In Sudan
we have a general concern that the use of antibiotic in many instances
unjustifiable in the medical field.
Design: prospective clinical and cross sectional studies.
Setting: Khartoum Dental Hospitals and Health Centers.
Objectives: Investigate the prescribing habits of antibiotics by general
dentists in Khartoum, Sudan.
Methods: The study consists of two questionnaires: The first one
investigated the therapeutic prescribing of antibiotics to patients attending
for emergency dental treatment. Information was collected via a
questionnaire concerning the patient’s reason for attendance and treatment
undertaken at emergency dental clinics in Khartoum state.
The second questionnaire: Investigated the knowledge of antibiotic
prescription by GDP’s in Khartoum State. Questionnaires were distributed
to General Practioners contracted to provide treatment in Khartoum health
centers and hospitals.
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Results: First questionnaire: Over a 12-week period 1,062 questionnaires
were collected in which 1,030 were useable. The majority of the attendees
had pain, 83.2% of these patients had pulpitis and 32% had been issued a
prescription for antibiotics, without any active surgical intervention. The
principal antibiotic prescribed for both adult and child patients was
combination of amoxicillin and metronidazole.
Second questionnaire: Results Responses to the questionnaire were
received from 322 (80.5%) practitioners. More than 85% of practitioners
recognised the need for prescribing antibiotics where there was evidence of
spreading infection. Some practitioners (28%) prescribed antibiotics for
acute pulpitis and (18 %) for chronic one. Antibiotics were prescribed by
practitioners before drainage of acute abscesses (33%) and by (90%) after
drainage. Practitioners were generally not influenced by patient’s
expectations of receiving antibiotics (88%), but would prescribe when
under pressure of time (21.9%), if they were unable to make a definitive
diagnosis (33.8%), or if treatment had to be delayed (71.52%). Amoxicillin
was the most frequently prescribed antibiotic used for most clinical
conditions followed by Amoxicillin with Calvulanic acid (brand name in
Sudan is Amoclan or Augmentin). There was a wide variety of dosage,
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frequency and duration for all the antibiotics used in the treatment of acute
dental infections.
Conclusion: The results obtained from both questionnaires have shown
that the prescribing of antibiotics by some GDP’s is not based on sound
clinical principles. Most of those surveyed used antibiotics routinely for
conditions where local treatment would suffice. It appears that there is a
need for interventions to promote rational use of antibiotics in the dental
field in Sudan.
Description
A thesis submitted to the University of Khartoum in partial fulfillment for the
requirements of the Master Degree in Conservative Dentistry
Keywords
University of Khartoum
antibiotics Misuse
Endodontics
Sudanese Dentists
Medical Studies Board
Citation
Rania Mohamed Daak, Antibiotic Misuse in Endodontics by Sudanese Dentists. – Khartoum : University of Khartoum, 2011. - 100 P. : illus., 28 cm., M.Sc.