TITLE:
Investigation of Antibiotic Use at a Dental Teaching Hospital in Yogyakarta, Indonesia: A Review from Guidelines
AUTHORS:
Mayu Winnie Rachmawati, Naoko Yoshida, Hirohito Tsuboi, Kazuko Kimura
KEYWORDS:
Appropriateness, Antibiotics Prescriptions, Dental Teaching Hospital, Guidelines
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.5 No.5,
May
22,
2014
ABSTRACT:
Objective: To investigate prescription of
antibiotics by dental practitioners at a dental teaching hospital in
Yogyakarta, Indonesia, and to establish whether it conforms to major
guidelines. Methods: A cross-sectional study of adult
outpatients’ medical records was conducted in order to scrutinize antibiotic
prescriptions. The results were compared with recommendations in four published
guidelines. Results: Dental practitioners prescribed a wide range of
antibiotics to treat 121 diagnoses. Amoxicillin (78.8%) was most commonly
prescribed, followed by clindamycin (9.9%), metronidazole (5.0%), and
lincomycin (2.1%). Among all prescriptions, 79.5% were for generic antibiotics.
The most common diagnoses were dental pulp gangrene followed by dental pulp
necrosis (26.7% and 8.8%, respectively). According to guidelines-1 through-4,
the percentages of antibiotic prescriptions that were evaluated as
appropriate for the reported diagnosis were 15.1%, 7.2%, 7.5%, and 16.3%,
respectively. However, 9.9%, 84.0%, 83.7% and 67.8% of prescriptions could not
be classified as appropriate or inappropriate because the respective guidelines
neither listed the antibiotic nor gave statement regarding appropriate
indications. Conclusion: Our results suggest that significant
inappropriate antibiotic prescribing occurred at a dental teaching hospital in
Yogyakarta, Indonesia, according to major antibiotics guidelines. However,
the four guidelines failed to list some antibiotics, failed to list indications
for prescription in some cases, and were inconsistent in their recommendations.
There is a need to introduce specific institutional guidelines. Our findings
should be helpful for developing public health policy guidelines to minimize
inappropriate antibiotic prescribing at dental hospitals.