Investigation of Antibiotic Use at a Dental Teaching Hospital in Yogyakarta, Indonesia: A Review from Guidelines

DOI: 10.4236/pp.2014.55062   PDF   HTML   XML   3,513 Downloads   4,691 Views   Citations

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.

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Rachmawati, M. , Yoshida, N. , Tsuboi, H. and Kimura, K. (2014) Investigation of Antibiotic Use at a Dental Teaching Hospital in Yogyakarta, Indonesia: A Review from Guidelines. Pharmacology & Pharmacy, 5, 524-531. doi: 10.4236/pp.2014.55062.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Kotwani, A., Chaundury, R.R. and Holloway, F.A.M. (2012) Antibiotic-Prescribing Practive of Primary Care Prescriber for Acute Diarrhea in New Delhi, India. Value in Health, 15, S115-S119.
http://dx.doi.org/10.1016/j.jval.2011.11.008
[2] Kuyvenhoven, M.M., van Balen, F.A.M. and Verheij, T.J.M. (2003) Outpatient Antibiotic Prescriptions from 1992 to 2001 in The Netherlands. Journal of Antimicrobial Chemotherapy, 52, 675-678.
http://dx.doi.org/10.1093/jac/dkg412
[3] Ashiru-Oredope, D., Sharland, M., Charani, E., McNulty, C. and Cooke, J. (2012) Improving the Quality of Antibiotic Prescribing in the NHS by Developing a New Antimicrobial Stewardship Programme: Start Smart-Then Focus. Journal of Antimicrobial Chemotherapy, 67, i51-i63.
http://dx.doi.org/10.1093/jac/dks202
[4] Lockhart, P.B., Loven, B., Brennan, M.T. and Fox, P.C. (2007) The Evidence Base for the Efficacy of Antibiotic Prophylaxis in Dental Practices. The Journal of the American Dental Association, 138,458-474.
http://jada.ada.org/content/138/4/458.full.pdf+html
[5] Akande, T.M., Ologe, M. and Medubi, G.F. (2009) Antibiotic Prescription Pattern and Cost at University of Ilorin Teaching Hospital, Ilorin, Nigeria. International Journal of Tropical Medicine, 4, 50-54.
[6] Palmer, N., Ireland, R. and Palmer, S. (1998) Antibiotic Prescribing Pattern of a Group of General Dental Practitioners: Result of a Pilot Study. Primary Dental Care, 5, 137-141.
[7] Aswapokee, N., Vaithayapichet, S., Heller, R.F. (1989) Pattern of Antibiotic Use in Medical Ward at Siriaj Hospital. Journal of Infectious Diseases and Antimicrobial Agents, 6, 79-82.
[8] Weinberg, M. and Froum, S.J. (2013) The Dentists’s Drug and Prescription Guide. 1st Edition, Wiley-Blackwell, UK.
[9] Scottish Dental Clinical Effectiveness Programme (2011) Drug Prescribing for Dentistry. 2nd Edition, Scottish National Health Service.
[10] Cambridgeshire National Health Science (NHS) Antibiotic Prescribing Guidelines for Dentists.
http://extranet.cambridgeshire.nhs.uk/Downloads/Healthcare%20Governance/Dental%20
information/Antibiotic%20Prescribing%20guidelines%20for%20Dentists.pdf
[11] National Guideline Clearinghouse (2008).
http://www.guideline.gov/content.aspx?id=47399&search=impacted+teeth
[12] Dajani, S.A., Taubert, K.A., Wilson, W., et al. (1997) Prevention of Bacterial Endocarditis. Circulation, 96, 358-366.
http://dx.doi.org/10.1161/01.CIR.96.1.358
[13] Afssaps (2012) Recommendations for Good Practice, Precription of Antibiotic for Oral and Dental Care. Médecine et Maladies Infectieuses, 42, 193-212.
[14] Roda, R.P., Bagan, J.V., Bielsa, J.M.S. and Pastor, E.C. (2007) Antibiotic Use in Dental Practice. A Review. Medicina Oral, Patología Oral y Cirugía Bucal, 12, E186-E192.
[15] Gour, R.P., Kohli, S., Advani, U., Kulshreshtha, A.J. and Parakh, R. (2013) Prescription Pattern of Antimicrobial Agents by Dental Practitioners: A Questionnaire Based Study. International Journal of Basic & Clinical Pharmacology, 2, 311-314.
[16] Adorka, M., Honore, M., Lubbe, M., Serfontein, J. and Allen, K.(2013) The Impact of Appropriate Antibiotic Prescribing on Treatment Evaluation Parameters. Journal of Public Health in Africa, 4, e2.
http://dx.doi.org/10.4081/jphia.2013.e2
[17] Karlowsky, J.A., Zhanel, G.G., Davidson, R.J. and Hoban, D.J. (1994) Once-Daily Aminoglycoside Dosing Assessment by MIC Reversion Time with Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy, 38, 11165-11168.
http://dx.doi.org/10.1128/AAC.38.5.1165
[18] (2012) Personal Interview. Unpublished
[19] Roy, K.M. and Bagg, J.(2000) Antibiotic Prescribing by General Dental Practitioners in the Greater Glasgow Health Board, Scotland, British Dental Journal, 188, 647-676.
http://dx.doi.org/10.1038/sj.bdj.4800574a
http://dx.doi.org/10.1038/sj.bdj.4800574

  
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