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Trends in antibiotic use and microbial diagnostics in periodontal treatment: comparing surveys of German dentists in a ten-year period

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Abstract

Objectives

The use of antibiotics and microbial tests in periodontal treatment among German dental practitioners was investigated in 2012–2013 and compared with 2002–2003 data.

Materials and methods

One thousand four hundred representative German practitioners received a postal questionnaire requesting their prescribing habits concerning type, dose, frequency, and sequence of antibiotics adjunctive to mechanical debridement. Additionally, the use of local antimicrobials and microbial tests were recorded.

Results

The response rate was 29.1 % (407 reports). Drug combinations, especially amoxicillin plus metronidazole, were prescribed most frequently (32.8 %) with an increase of 7.4 % during the past decade, followed by clindamycin (29.3 %). Amoxicillin monotherapy was used unexpectedly frequently (17.0 %) and doxycycline (2.8 %) very infrequently. Then, 24.7 % prescribed antibiotics prior to mechanical therapy, while most dentists followed the recommended sequence. The use of local antimicrobials increased by 6.2 % and of microbial diagnostics by 20.8 %.

Conclusions

Positive trends regarding position-paper-conform prescribing habits including the scheduling of systemic antibiotics and increasing use of local antimicrobials and microbial tests were observed. However, deficits and malpractice still exist in German practices. Unexpected is the widespread and increasing use of clindamycin. Continuing educational campaigns and strictly expressed real guidelines are needed.

Clinical relevance

Indication and choice of antibiotic agents in causal periodontal therapy among German dentists have changed between 2003 and 2013 toward a more position-paper-based concept, but inappropriate prescriptions of second choice antibiotics still remain conspicuous.

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Acknowledgments

We thank Christina Fitzner and Miriam Tamm from the Institute of Medical Statistics of RWTH Aachen University for their support during the planning and evaluation phase. Furthermore, we would like to thank the many anonymous dentists who participated in the study. No external funding, apart from the support of the authors’ institution, was available for this study.

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Authors and Affiliations

  1. Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Pauwelsstrasse 30, D-52074, Aachen, Germany

    Svenja Falkenstein, Karsten Henne & Georg Conrads

  2. Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany

    Jamal M. Stein

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  1. Svenja Falkenstein
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Correspondence to Georg Conrads.

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The work was supported by the Department for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany.

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Falkenstein, S., Stein, J.M., Henne, K. et al. Trends in antibiotic use and microbial diagnostics in periodontal treatment: comparing surveys of German dentists in a ten-year period. Clin Oral Invest 20, 2203–2210 (2016). https://doi.org/10.1007/s00784-016-1722-6

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