Evaluation of Knowledge and Performance of General Dentists in Shiraz, Iran, Regarding Antibiotic Prescription in Endodontic Treatments (2024).

Abstract

Background: Inappropriate antibiotic prescribing in dentistry contributes significantly to global antibiotic resistance. Clinical guidelines published by the American association of endodontists (AAE) explicitly state that clinicians should avoid prescribing antibiotics for uncomplicated dentoalveolar infections unless systemic symptoms are present. Evaluation of compliance with current antibiotic prescribing guidelines and identifying the gaps between knowledge and clinical performance of clinical practitioners is essential.

Purpose: This study was conducted to assess the knowledge and clinical performance regarding antibiotic use in endodontic treatments among general dentists in Shiraz, Iran, regarding the latest AAE guidelines.

Materials and method: A cross-sectional study was conducted using a validated questionnaire (Content Validity Index= 0.89, Cronbach's α= 0.82) distributed to 140 general dentists and residents in Shiraz via random sampling. The questionnaire assessed (1) demographic characteristics, (2) knowledge of current guidelines, and (3) clinical prescribing performance through case scenarios. We analyzed data from 103 completed responses using IBM SPSS v27.0 (IBM Corp., Armonk, NY, USA) with descriptive statistics, chi-square tests, and binary logistic regression (p Value < 0.05).

Results: While participants demonstrated moderate to good theoretical knowledge (70.9% correctly identified first-line antibiotics), significant gaps existed in clinical application. Notably, 69.9% of participants prescribed antibiotics inappropriately for immunocompromised patients. Residents exhibited significantly better practical guideline compliance than general practitioners (p= 0.019). No significant associations were found with gender, clinical experience, or workplace. Also, 88.3% expressed need for further training.

Conclusion: Considering moderate to good knowledge, coupled with a low to moderate performance level, significant deviations from AAE guidelines highlight the need for targeted educational interventions, including workshops and curriculum integration, to improve antibiotic stewardship.