The compliance of dentists toward prescribing prophylaxis antibiotic for special care patients at risk of having infective endocarditis

Abstract

Background: Prescribing antibiotics (Abs) as a prophylactic before dental procedures is recommended by the American Academy of Pediatric Dentistry (AAPD) in patients with cardiac diseases to prevent a potentially life-threatening infection of the cardiac valves or endocardium called “infective endocarditis (IE).” Aim: This study aimed to assess the compliance of dentists in Makkah city with the AAPD recommendations of prescribing prophylaxis Abs for special care pediatric patients at risk of having IE. Materials and Methods: This was an observational cross-sectional study among dentists who are working at the major hospitals in Makkah city, Saudi Arabia. Participants' perception regarding the prescription of prophylactic Abs was measured using validated and reliable questions. The reliability analysis was used with a model of alpha (Cronbach) to study the properties of measurement scales and the items that compose the scales and the average inter-item correlation. Results: One hundred and thirty-two dental practitioners were participated. Dental care providers would prescribe Abs with dental extraction (92.4%), periodontal surgery (89.4%), nonsurgical root canal treatment beyond apex (77.3%), supragingival scaling (67.4%), and retraction cord placement (46.2%). On the other hand, dental practitioners would not prescribe Abs for orthodontic appliance (87.9%), intraoral radiograph (87.1%), primary teeth shedding (81.8%), tooth preparation when taking an oral impression (76.5%), local anesthesia infiltration (68.2%), and restoration of Class II caries with matrix and wedge (56.8%). A significantly lower knowledge score was obtained by general dental practitioners when compared with consultant and specialists (P = 0.044). Consultants and specialists recorded significantly lower knowledge on the prescription of prophylaxis Abs for Class II caries with matrix and wedge (P < 0.001) when compared with general dental practitioners. Conclusions: Most dentists followed the AAPD recommendations of prophylactic Abs for children who have a high risk of developing IE. However, Class II dental restorations with matrix and wedge and placement of retraction cord have recorded more invalid responses. General dental practitioners had lower knowledge when compared with consultants and specialists when prescribing Abs for children who have a high risk of developing IE.