The Antibiotic Prescription Trend of Dentists for Endodontic Treatment from a Region of Pakistan: An Online Survey.

Purpose: Globally the overuse of systemic antibiotics is now a serious concern for the health professionals. The increase in antimicrobial resistant bacteria because of this practice has made treatment of infections ever more difficult. In providing endodontic treatment it has been found that many dentists are either misusing or overusing systemic antibiotics. The objective of this study was to assess the antibiotic prescribing trends of dentists in a region of Pakistan and if any association could be made of such practices with the experience of the dentist. Methodology: This cross sectional study was based on an on line questionnaire. A total of 150 invitation were sent by emails and social media groups like ’Whattsapp’. This estimation of respondents was made by calculating the total fresh graduates and clinical dental faculty of the three dental institute of the region. The online survey was designed on the checklist based on Checklist for Reporting Results of Internet E-surveys (CHERRIES). SPSS version 20 was used to analyze the data. Chi square test was used with p- value< 0-05. Results: There was an 84% response rate on this online questionnaire. Most of the participants (71.5%) were aware of guidelines for antibiotic use.  Only 12.30% participants as a whole had attended a seminar or workshop in the last one year on recent guidelines for antibiotic prescription.  Of the total, 42.30% of the respondents were prescribing antibiotics to 2-3 patients on a daily basis. Majority of the respondents (63.84%) would prefer penicillin’s as the first choice of antibiotic if needed. But 62.7% of the fresh graduates would advise systemic antibiotics in a case of endodontic flare up where there is no recommendation or justification. With 44.7% dental practitioners’ prescribing antibiotics in the same scenario it was statistically significant (p=0.0480). Recommendations: Globally, the overuse of antibiotics is a trend which is concerning, here in the region of Abbottabad, Pakistan this same trend is present.  Dental health care providers must understand that prescription of systemic antibiotics when not recommended may lead to antimicrobial resistance, whereas non-prescription when necessary may have detrimental health consequences. So the practitioners’ knowledge of guidelines is irrelevant as long as they are not practicing it. Hence the rationale for not practicing on the guidelines is what needs to be further investigated in future studies.