DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20204500

Antibiotics usage, how well we know it? KAP survey among the dentist population in Mumbai

Amisha N. Parekh, Karthik Balasubramanian, Purvi Bhate, Dheeraj D. Kalra

Abstract


Background: There is a rising concern for antibiotic resistance worldwide, the primary cause of which is overuse and misuse. This study primarily aimed at assessing the knowledge of dental practitioners regarding the current guidelines on use of antibiotics and to identify the shortcomings if any.

Methods: Present study was a cross-sectional questionnaire-based study conducted amongst 450 dental practitioners across Mumbai with the help of a self-designed questionnaire. The data was entered into excel sheets and appropriate statistical analysis was done with chi-square test using SPSS version 20.

Results: The present study had a response rate of 95%. For the total percentage of patients examined each day that required systemic antibiotics, 36.9% (153) dentists answered 0-5%, followed by 25.3% (105) answered 10-15%. 76.1% (316) dentists came across patients who had self-prescribed antibiotics. 66% (274) dentists had never advised an antibiotic sensitivity/ culture test for their patients. 51.3% (213) dentists came across patients who did not respond to antibiotics. 87.2% (363) dentists were not aware about the ‘AWaRe’ classification of antibiotics given by WHO. 93.3% (383) dentists did not know about antimicrobial stewardship concept.

Conclusions: The present study reflected antibiotic overuse and misuse to a certain extent by dental practitioners across Mumbai. Most dentists were unaware about ‘AWaRe’ classification and antimicrobial stewardship. Patient education on ill effects of self-prescription of antibiotics, identification of traits of antibiotic resistance and antibiotic culture tests needs to be prioritized by dentists.


Keywords


Antimicrobial stewardship, Antibiotic resistance, Antibiotics survey, AWaRe, Dental practitioners

Full Text:

PDF

References


Interagency coordination group on antimicrobial resistance no time to wait: securing the future from drug-resistant infections report to the secretary-general of the United Nations. Available at: https://www.who.int/antimicrobial-resistance/ interagency-coordination-group/IACG_final_report_ EN.pdf?ua=1. Accessed on 22 November 2019.

American dental association council on scientific affairs. Combating antibiotic resistance. J Am Dent Assoc. 2004;135(4):484-7.

Agnihotry A, Gill KS, Stevenson IRG, Fedorowicz Z, Kumar V, Sprakel J, et al. Irreversible pulpitis - a source of antibiotic over-prescription?. Braz Dent J. 2019;30(4),374-9.

Kaul R, Angrish P, Jain P, Saha S, Sengupta A, Mukherjee S. A survey on the use of antibiotics among the dentists of Kolkata, West Bengal, India. Int J Clin Pediatr Dent. 2018;11(2):122‐7.

World health organization, antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries: a WHO practical toolkit (2019). Available at:https://apps.who.int/iris/handle/ 10665/329404. Accessed on 20 August 2020.

World health organization, global action plan on antimicrobial resistance (2015). Available at: https://apps.who.int/iris/handle/10665/193736. Accessed on 20 August 2020.

Dyar OJ, Huttner B, Schouten J, Pulcini C. ESCMID study group for antimicrobial stewardship: What is antimicrobial stewardship?. Clin Microbiol Infect. 2017;23(11):793‐8.

Centers for disease control and prevention, antibiotic resistance a global threat. Available at: https://www.cdc.gov/drugresistance/solutions-initiative/stories/ar-global-threat.html. Accessed on 20 August 2020.

Mohan S, Thakur J. A questionnaire based survey on the antibiotic prescription pattern of dentists in eastern part of India. Int J Contemp Med Res. 2019;6(4):D16¬-9.

Gorstein J, Sullivan KM, Parvanta I, Begin F. Indicators and methods for cross-sectional surveys of vitamin and mineral status of populations. Available at: https://www.who.int/vmnis/toolkit/mcn-micronutrient-surveys.pdf. Accessed on 20 August 2020.

Kumar KP, Kaushik M, Kumar PU, Reddy MS, Prashar N. Antibiotic prescribing habits of dental surgeons in hyderabad city, India, for pulpal and periapical pathologies: a survey. Adv Pharmacol Sci. 2013;2013:537385.

Naveen N, Guru SP, Vanishree N, Patnaik S, Bharath C, Keerthi PKS, et al. Current trends in prescription of antibiotics among dentists working in various dental colleges of Bangalore city, India- a cross sectional study. Int J Oral Health Med Res. 2015;2(2):8-14.

Keenan JV, Farman AG, Fedorowicz Z, Newton JT. A cochrane systematic review finds no evidence to support the use of antibiotics for pain relief in irreversible pulpitis. J Endod. 2006;32(2):87‐92.

Lockhart PB, Tampi MP, Abt E, Aminoshariae A, Durkin M, Fouad A, et al. Evidence based clinical practice guideline on antibiotic use for the urgent management of pulpal and periapical-related dental pain and intraoral swelling: A report from the American dental association. J Am Dent Assoc. 2019;150(11):906‐21.

American association of endodontists, AAE quick reference guide on antibiotic prophylaxis 2017 update. Available at: https://www.aae.org/ specialty/wp-content/uploads/sites/2/2017/06/ aae_antibiotic-prophylaxis-2017update.pdf. Accessed on 20 August 2020.

Sollecito TP, Abt E, Lockhart PB, Edmund T, Thomas P, Sharon T, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners-a report of the American dental association council on scientific affairs. J Am Dent Assoc. 2015;146(1):11‐6.

Dineshkumar B, Raghuram TC, Radhaiah G, Krishnaswamy K. Profile of drug use in urban and rural India. Pharmacoeconomics. 1995;7(4):332‐46.

Larato DC. The antibiotic sensitivity test in dental practice. Oral Surg Oral Med Oral Pathol. 1966;22 (5):682‐7.

Singh DP, Sampath N, Mahuli AV, Yadav H, Mahuli SA, Yadav R. Knowledge regarding antibiotic drug action and prescription practices among dentist in Jaipur city, Rajasthan. J Dent Res Rev. 2015;2:127-9.

Ranjalkar J, Chandy SJ. India's National action plan for antimicrobial resistance – an overview of the context, status, and way ahead. J Family Med Prim Care. 2019;8:1828-34.

Sanchez GV, Fleming-Dutra KE, Roberts RM, Hicks LA. Core elements of outpatient antibiotic stewardship. MMWR Recomm Rep. 2016;65:1-12.

Gross AE, Hanna D, Rowan SA, Bleasdale SC, Suda KJ. Successful implementation of an antibiotic stewardship program in an academic dental practice. Open Forum Infect Dis. 2019;6(3):ofz067.

Bennadi D. Antimicrobial stewardship - an alarming call in dentistry. Int J Pharm Pharm Sci. 2014;6:46-9.