Effect of an educational intervention among Lebanese dentists on antibiotic prescribing: a randomized controlled study.

OBJECTIVES: To investigate whether an educational intervention could improve antibiotic prescribing among Lebanese dentists and assess antibiotic prescribing patterns regarding international guidelines. MATERIALS AND METHODS: An interventional randomized controlled trial was conducted from the first of April to the end of August 2017. This was an oral presentation of about 20 min based on a review of the literature and the international guidelines. Sixty dentists specializing in oral dental surgery or general practitioners participated in this study. All the patients who took a consultation over 2 months were involved. RESULTS: In this study, 950 antibiotic prescriptions were analyzed. A change was found only in antibiotics prescribed for tooth extraction and tooth extraction (impacted tooth). The intervention was impactful in raising the mean percentage of prescriptions compliant with indication and with the choice regarding antibiotics prescribed for prophylactic reasons. A dentist in the intervention group would have after the intervention period a mean percentage of prescriptions compliant with indication and with choice of 31.7% and 20.7%, respectively, above one in the control group. Despite the decrease in the overall number of antibiotics prescribed by dentists in the intervention group over time, this does not suggest that this was solely due to the effect of the intervention. CONCLUSION: This study highlights the importance of continuing medical education to optimize antibiotic use in dentistry. CLINICAL RELEVANCE: This study can serve as the basis for a future audit, training, and feedback intervention to increase dentists' awareness of recommended guidelines and optimal antibiotic use.

An evaluation of prophylactic and therapeutic antibiotic prescribing in Lebanese dental practice.

OBJECTIVES: To evaluate antibiotic prescribing patterns and correlates among Lebanese dentists. METHODS: A descriptive observational study was conducted, from the first of April to the end of May 2017. Dentists who specialized in oral dental surgery or general dental practitioners were eligible to participate in this study. All patients who sought consultation with the selected dentists over a 1 month period were included. KEY FINDINGS: A total of 2323 oral and dental procedures were performed by 60 dentists; 553 antibiotic prescriptions were prescribed, representing 23.8% (52.35% for prophylactic purposes and 47.65% for curative purposes). Prophylactic indications were mainly for implant surgery (36.3%) with only 1% appropriate. Curative use was mainly for periodontal abscesses/abscesses (indeterminate) (22.8%), followed by pulpal diseases and periradicular complications (20.5%); it was appropriate in only 1.7 and 1.9% of cases respectively. Amoxicillin-clavulanic acid was the antibiotic that was mostly prescribed for both curative and prophylactic uses (57.6 and 55.9%, respectively), followed by amoxicillin for prophylactic purposes and a combination of spiramycin plus metronidazole for curative purposes. Adherence to guidelines was low for both curative and prophylactic purposes (17.4 and 21.8%, respectively), but was better in patients who were younger [adjusted odds ratio(aOR) = 0.96], male (aOR = 0.40), or had cardiac disease with moderate or high infective endocarditis risk (aOR = 21.72), and when prescribed by oral surgeons (aOR = 0.15). CONCLUSIONS: This study showed evidence of the overuse of antibiotics among Lebanese dentists. It can serve as a basis for future studies to optimize antibiotic use among dentists in Lebanon.