Masters theses : Medicine

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    Knowledge, Attitude and Practice of General Dental Practitioner Regarding Prescription of Antibiotics in Khartoum Dental Teaching Hospital,2017
    (Al Neelain University, 2017-07) Tawassul Abdul Raheem Othman Mohammed
    Introduction: Dentists prescribe antibiotics for the management of a number of oral conditions, since most human orofacial infections originate from odontogenic infections, the prescribing of antibiotics by dental practitioners has become an important aspect of dental practice. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, Inappropriate antibiotics prescription by dentists that contribute in the emergence of antibiotic-resistant bacteria is a worldwide concern. Objectives: To study the knowledge, attitude and practice of the general dental practitioner regarding prescription of antibiotics, in Khartoum dental teaching hospital. Methodology: Hospital based descriptive cross sectional study, conducted in Khartoum dental teaching hospital in 2017, targeted a total population of 194 general dental practitioners working in hospital at the time of study. A Self-administered, structured questionnaire composed of four sections personal data, knowledge assessment section, attitude section and practice assessment section was constructed and given to all of our targeted population (total coverage). Data was computed and analyzed using SPSS 23 software. Descriptive statistics was performed Results: The response rate for this study was 63.08% as 123 dentists out of 194 responded to the questionnaire. The majority being female, only 13.01% of respondents had take a post graduate education. Just 28.5%, 22.8% know the exact prophylaxis regimen for those with no allergy to penicillin and those with allergy respectively.The most common antibiotics prescribed was the combination of amoxicillin and metronidazol followed by amoclan 625 mg and for patients with allergy to penicillin erythromycin followed by clindamycin 300 mg . Among respondents 69.1% would prescribe prophylaxis for patients with prosthetic joint implant and 83.7% for patients with history of organ transplantation. 65.9% used to prescribe antibiotics regularly after teeth extraction. 71.5% would prescribe antibiotics for Irreversible Pulpitis, moderate/severe preoperative symptoms. A considerable number of responding dentist would prescribe antibiotics for Prevention of postoperative complications .About non clinical factors the rates were26.0% , 33.3%, 16.3%, 56.1% for Unsure of diagnosis, Pressure of time and workload, Patient’s expectation of antibiotic and Delay/ unable to complete treatment respectively . Conclusion: This study supports the conclusion that there is overprescribing of antibiotics, lack of knowledge about the correct indication, type, and dosage of antibiotics in dental practice. Large proportion of respondents were found to prescribe antibiotics due to non-clinical and a significant number of the practitioners surveyed prescribe prophylactic antibiotics inappropriately, Recommendations: The results suggest that there is a need for Improving undergraduate & postgraduate education by the ministry of higher education and researches and the medical council .There is also an urgent need for consistent antimicrobial policies to be taught in dental schools , in addition to community awareness programs for the dentists about the global problems of misuse of antibiotics this could be achieved by the coordination and cooperation between the different directorate in ministry of health. Antibiotic Research in the efficacy and indications for antibiotic use, to provide evidence- based regimens for general dental practitioners should be encouraged and be one of researches priorities by the National council of research and directorate of research.