Sinan ŞERMET, Müşerref AKGÜN, Şükran ATAMER-ŞİMŞEK

Oral hastalıkların tedavisinde, İstanbul’daki diş hekimleri arasında antibiyotik reçetelendirme profili

Amaç: İstanbul’daki diş hekimleri tarafından, akılcı ilaç kullanımını, dental tedavi amacıyla antibiyotiklerin verilme nedenlerini ve ilaç konusunda hastaya verilen bilgileri belirlemek.Yöntem: İstanbul’da çalışan 250 diş hekimine anket dağıtıldı. Anketler, hekimlere elden verildi. Anketteki sorular; diş hekimliğinde, terapötik ve profilaktik antibiyotik kullanımı hakkında açık uçlu sorulardı. Anketler analiz edildi ve her bir soruya verilen yanıtlar, mutlak frekanslar olarak belirlendi. Vakalar ve diş hekimleri tarafından her bir vaka için reçete edilen antibiyotikler, tanımsal istatistik yöntemi olan sıklıkla analiz edildi.Bulgular: Dağıtılan anketlerin 130 adedi yanıtlandı (%52). Başlıca yazılan antibiyotikler; tedavi amacıyla amoksisilin ve klavulanik asit kombinasyonu, profilaksi amacıyla amaoksisilin idi. Diş hekimlerinin %80’inden fazlası hastalarına antibiyotikle ilgili bilgi verdiğini belirtmesine karşın, verilen bilginin içeriği kısıtlıydı. Hastalar, yazılan ilaçların dozlarına ve doz aralıklarına uymaları konusunda bilgilendirilmişlerdi.Sonuç: Mevcut çalışma, diş hekimlerinin; periodontal, endodontik ve cerrahi işlemlerin tedavisi için en fazla yazdıkları antibiyotiğin; amoksisilin klavulanik asit olduğunu göstermiştir. Sonuçlar ayrıca, diş hekimlerinin hastalarını antibiyotik kullanımı konusunda yetersiz şekilde bilgilendirdiğini göstermiştir. Bu verilerin ışığında, gereksiz antibiyotik kullanımı, ilaç kullanımı konusunda hastaların yetersiz bilgilendirilmesi ve akılcı olmayan ilaç kullanımı, lisans ve lisansüstü eğitimin yenilenmesi gerektiğini göstermektedir.Anahtar Kelimeler: Diş hekimliği, antibiyotik kullanımı, anket

Anahtar Kelimeler:

Diş hekimliği, antibiyotik kullanımı, anket

Antibiotic prescribing profile in the management of oral diseases among dentists in Istanbul

Objectives: To determine the rational drug use and the pattern of antibiotic prescription for dental management and the information given to their patients about the use of these drugs by dentists in Istanbul.Methods: A questionnaire was distributed to 250 dentists working in Istanbul. The questionnaires consist of open-ended questions about therapeutic and prophylactic antibiotic use in dentistry and were given by hand to dentists. The questionnaires were analyzed and the responses to each question expressed as absolute frequencies. The cases and the antibiotics prescribed by dentists for each case were determined by the descriptive statistics method; “frequency”.Results: Responses to questionnaire were received from 130 (52%) dentists. Primarily prescribed antibiotic for therapy was the combination of amoxicillin and clavulanic acid and for prophylaxis was amoxicillin. Although more than 80% of the dentists reported they gave information to their patients about the use of antibiotics, the content of the information was limited. Patients mainly informed to obey the dose and dose intervals of the prescribed drugs by dentists.Conclusions: The results of the present study demonstrated that dentists most commonly prescribe the combination of amoxicillin and clavulanic acid for the therapy of periodontal, endodontic and surgical procedures. The results also showed that dentists informed their patients inadequately about antibiotic use. In the light of these data; inessential antibiotic use, insufficient informing of the patients about drug use and irrational use of drugs indicate that the renovation of graduate and postgraduate educations are required.

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Poveda – Roda R, Bagàn JV, Sanchis – Bielsa JM, Carbonell – Pastor E. Antibiotic use in dental practice, a review. Med Oral Patol Oral Cir Bucal. 2007; 12: 186-192.
Palmer NAO, Pealing R, Ireland RS, Martin MV. A study of therapeutic antibiotic prescribing in National Health Service general dental practice in England. Br Dent J. 2000;188 (10): 554-558.
Salako NO, Rotimi VO, Adib SM, Al-Mutawa S. Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait. J Dent. 2004;32(7): 503-509.
Kuriyama T, Nakagawa K, Karaswa T, Saiki Y, Yamamoto E, Nakamura. Past administration of beta – laktam antibiotics and increase in the emergence of beta – lactamase – producing bacteria in patients with orofacial odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89: 186-192.
Groppo FC, Castro FM, Pacheo AB, Motta RH, Filho TR, Ramacciato JC, et al. Antimicrobial resistance of Staphylococcus aureus and oral streptococci strains from high – risk endocarditis patients. Gen Dent. 2005; 53: 410-413.
Aracil B, Minabres M, Oteo J, Torres C, Gomez – Garces JL, Alos JI. High prevalence of erythromycin – resistant and clindamycin – susceptible (M phenotype) viridans group streptococci from pharyngeal samples: a reservoir of mef genes in commensal bacteria. J Antimicrob Chemothe. 2001; 48: 592-94.
De Vries TPGM, Henning RH, Hozergeil HV, Fresle DA Guide to good prescribing. Action programme on essential drugs. Geneva, WHO: 1994.
Akıcı A, Kalaça S, Uğurlu MU, Toklu HZ, Iskender E, Oktay S. Patient knowledge about drugs prescribed at primary healthcare facilities. Pharmacoepidemiol Drug Saf. 2004;13(12): 871-876.
Atamer Şimsek Ş, Güven Y. Best Practice-77 Problem Cases, Solutions, Prescriptions and Laboratory Tests in Dental Practice. Quintessence Pub 2009.
Palmer NAO, Pealing R, Ireland RS, Martin MV. A study of prophylactic antibiotic prescribing in National Health Service general dental practice in England. Br Dent J. 2000; 189 (1): 43-46.
Tong DC, Rothwell BR. Antibiotic prophylaxis in dentistry: a review and practice recommendations. J Am Dent Assoc. 2000;131(3):366- 374.
Gould FK, Elliott TS, Foweraker J, Fulford M, Perry JD, Roberts GJ, Sandoe JA, Watkin RW, Working Party of the British Society for Antimicrobial Chemotherapy. Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother. 2006; 57(6):1035-1042.
Peterson LJ. Antibiotics for oral and maxillofacial infections In: Antibiotic and Antimicrobial Use in Dental Practice. 2nd ed. Newman MG, van Winkelhoff AJ (eds) Quintessence Pub 2001; 157-174.
Ciancio SG. Van Winkelhoff AJ. Antibiotics in periodontal therapy. In: Antibiotic and Antimicrobial Use in Dental Practise. 2nd ed. Newman MG, van Winkelhoff AJ (eds) Quintessence Pu.b 2001; 113-126.
Carranza FA, Adams DF, Newman MG. Slowly progressive periodontitis / rapidly progressive periodontitis, necrotizing ulcerative In: Clinical periodontology. ed. Fermin A Carranza, Michael G Newman. 8th ed, Saunders Co. 1996 p. 326–329 / 329-335.
Jacobs RA, Guglielmo BJ. Anti – infective Chemotherapeutic & antibiotic agents. In: Current medical diagnosis & treatment. Tierney LM, McPhee SJ, Papadakis MA (eds). 42nd ed. Lange Medical Boks/ McGraw Hill. 2003 p. 1495-1535.
Baumgartner JC. Antibiotics in endodontic therapy. In: Antibiotic and Antimicrobial Use in Dental Practise. 2nd ed. Newman MG, van Winkelhoff AJ (eds) Quintessence Pub. 2001; 143-157.
Otomo-Corgel J. Considerations for female patients. In: Antibiotic and Antimicrobial Use in Dental Practice. 2nd ed. Newman MG, van Winkelhoff AJ (eds) Quintessence Pub.2001; 235-242.
Lacy CF, Armstrong LL, Goldman MP, Lance LL. Charles F, Armstrong LL, Goldman MP, Lance LL. Drug Information Handbook POCKET 2002 – 2003 Lexi-Comp Inc. p. 76, 911-913
Phsicians’ Desk Reference PDR 62nd Edition 2008. p. 1347, 1349-1350.
Lindermann R, Harrington D. Pediatric Considerations. In: Antibiotic and Antimicrobial Use in Dental Practice. 2nd ed. Newman MG, van Winkelhoff AJ (eds) Quintessence Pub. 2001; 155-182.
Robert GJ, Hozel HS, Sury MR, Simmons NA, Gardner P, Longhurst P. Dental bacteriemia in children. Pediatr Cardiol. 1997; 18: 24-7.
Schröder U. Pedodontic endodontics In: Pediatric dentistry – a clinical approach ed. Koach G, Poulsen S. (eds) 2001; 213-233.
Kishiyama JL, Adelman DC. Current medical diagnosis & therapy. In: Allergic & immunologic disorders. ed. Lawrence M Tierney, Stephen J McPhee, Maxine A Papadakis, 42nd ed. Lange Medical Books / Mc Graw Hill 2003; 759-782.
Lucas V, Robert GJ. Odontogenic bacteremia folowing tooth cleaning procedures in children. Pediatric Dent. 2000;22: 96-101.
Brook I, Calhoun L, Yocum P. Beta-lactamase-producing isolates of Bacteroides species from children. Antimicrob Agents Chemother. 1980; 18(1):164-166.