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Effect of an educational intervention among Lebanese dentists on antibiotic prescribing: a randomized controlled study

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Abstract

Objectives

To investigate whether an educational intervention could improve antibiotic prescribing among Lebanese dentists and assess antibiotic prescribing patterns regarding international guidelines.

Materials and methods

An interventional randomized controlled trial was conducted from the first of April to the end of August 2017. This was an oral presentation of about 20 min based on a review of the literature and the international guidelines. Sixty dentists specializing in oral dental surgery or general practitioners participated in this study. All the patients who took a consultation over 2 months were involved.

Results

In this study, 950 antibiotic prescriptions were analyzed. A change was found only in antibiotics prescribed for tooth extraction and tooth extraction (impacted tooth). The intervention was impactful in raising the mean percentage of prescriptions compliant with indication and with the choice regarding antibiotics prescribed for prophylactic reasons. A dentist in the intervention group would have after the intervention period a mean percentage of prescriptions compliant with indication and with choice of 31.7% and 20.7%, respectively, above one in the control group. Despite the decrease in the overall number of antibiotics prescribed by dentists in the intervention group over time, this does not suggest that this was solely due to the effect of the intervention.

Conclusion

This study highlights the importance of continuing medical education to optimize antibiotic use in dentistry.

Clinical relevance

This study can serve as the basis for a future audit, training, and feedback intervention to increase dentists’ awareness of recommended guidelines and optimal antibiotic use.

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Data availability

The data that support the findings of this study are available within the article and for supplementary materials from the corresponding author upon reasonable request. Email address: nadineshehab@hotmail.com.

References

  1. Gulliford MC, Moore MV, Little P, Hay AD, Fox R, Prevost AT, et al 2016 Safety of reduced antibiotic prescribing for self limiting respiratory tract infections in primary care: cohort study using electronic health records BMJ 354 i3410

  2. Kenealy T, Arroll B 2013 Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev 6 CD000247

  3. Little P, Stuart B, Moore M, Coenen S, Butler CC, Godycki-Cwirko M et al (2013) Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial. Lancet Infect Dis 13(2):123–129

    Article  Google Scholar 

  4. Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM et al (2016) Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA 315(17):1864–1873

    Article  Google Scholar 

  5. Kantor ED, Rehm CD, Haas JS, Chan AT, Giovannucci EL (2015) Trends in prescription drug use among adults in the United States from 1999–2012. JAMA 314(17):1818–1831

    Article  Google Scholar 

  6. WHO | Antimicrobial resistance: global report on surveillance 2014. WHO.

  7. Löffler C, Böhmer F, Hornung A, Lang H, Burmeister U, Podbielski A et al (2014) Dental care resistance prevention and antibiotic prescribing modification—the cluster-randomised controlled DREAM trial. Implement Sci 9(1):27

    Article  Google Scholar 

  8. Cope AL, Chestnutt IG (2014) Inappropriate prescribing of antibiotics in primary dental care: reasons and resolutions. Prim Dent J 3(4):33–37

    Article  Google Scholar 

  9. Johnson TM, Hawkes J (2014) Awareness of antibiotic prescribing and resistance in primary dental care. Prim Dent J 3(4):44–47

    Article  Google Scholar 

  10. Koyuncuoglu CZ, Aydin M, Kirmizi NI, Aydin V, Aksoy M, Isli F et al (2017) Rational use of medicine in dentistry: do dentists prescribe antibiotics in appropriate indications? Eur J Clin Pharmacol 73(8):1027–1032

    Article  Google Scholar 

  11. Bolfoni MR, Pappen FG, Pereira-Cenci T, Jacinto RC (2018) Antibiotic prescription for endodontic infections: a survey of Brazilian Endodontists. Int Endod J 51(2):148–156

    Article  Google Scholar 

  12. Ocek Z, Sahin H, Baksi G, Apaydin S (2008) Development of a rational antibiotic usage course for dentists. Eur J Dent Educ Off J Assoc Dent Educ Eur 12(1):41–47

    Article  Google Scholar 

  13. Kaptan RF, Haznedaroglu F, Basturk FB, Kayahan MB (2013) Treatment approaches and antibiotic use for emergency dental treatment in Turkey. Ther Clin Risk Manag 9:443–449

    PubMed  PubMed Central  Google Scholar 

  14. Llor C, Cots JM, Gaspar MJ, Alay M, Rams N (2009) Antibiotic prescribing over the last 16 years: fewer antibiotics but the spectrum is broadening. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol 28(8):893–897

    Article  Google Scholar 

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

    Article  Google Scholar 

  16. Löffler C, Böhmer F. 2017 The effect of interventions aiming to optimise the prescription of antibiotics in dental care-a systematic review. PloS One 12 11 e0188061

  17. Mansour H, Feghali M, Saleh N, Zeitouny M, Mansour H, Feghali M, et al. 2018 Knowledge, practice and attitudes regarding antibiotics use among Lebanese dentists. Pharm Pract Granada 16 3

  18. Chehabeddine N, Lahoud N, Noujeim ZEF, Zeidan RK, El Toum S, Maison P et al (2022) An evaluation of prophylactic and therapeutic antibiotic prescribing in Lebanese dental practice. Int J Pharm Pract 30(1):75–81

    Article  Google Scholar 

  19. Lesclous P (2011) Prescription des antibiotiques en pratique bucco-dentaire: recommandations Afssaps 2011. Médecine Buccale Chir Buccale 17(4):334–346

    Article  Google Scholar 

  20. Société Française de Chirurgie Orale (2012) Prise en charge des foyers infectieux bucco-dentaires. Médecine Buccale Chir Buccale 18(3):251–314

    Article  Google Scholar 

  21. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M et al (2007) Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 116(15):1736–1754

    Article  Google Scholar 

  22. Gould FK, Elliott TSJ, Foweraker J, Fulford M, Perry JD, Roberts GJ et al (2006) Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 57(6):1035–1042

    Article  Google Scholar 

  23. Chate R a. C, White S, Hale LRO, Howat AP, Bottomley J, Barnet-Lamb J, et al. The impact of clinical audit on antibiotic prescribing in general dental practice. Br Dent J 2006 201 10 635 41

  24. Chopra R, Merali R, Paolinelis G, Kwok J (2014) An audit of antimicrobial prescribing in an acute dental care department. Prim Dent J 3(4):24–29

    Article  Google Scholar 

  25. Zahabiyoun S, Sahabi M, Kharazi MJ (2015) Improving knowledge of general dental practitioners on antibiotic prescribing by raising awareness of the Faculty of General Dental Practice (UK) Guidelines. J Dent Tehran Iran 12(3):171–176

    Google Scholar 

  26. Palmer N, Dailey Y, Martin M (2001) Can audit improve antibiotic prescribing in general dental practice? Br Dent J 191(5):253–255

    Article  Google Scholar 

  27. Soheilipour S, Scambler S, Dickinson C, Dunne SM, Burke M, Jabbarifar SE, et al. 2011 Antibiotic prophylaxis in dentistry: part I. A qualitative study of professionals’ views on the NICE guideline. Br Dent J 211 1 E1

  28. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA et al (1999) Why don’t physicians follow clinical practice guidelines? A framework for improvement JAMA 282(15):1458–1465

    PubMed  Google Scholar 

  29. Palmer NA, Pealing R, Ireland RS, Martin MV (2000) A study of therapeutic antibiotic prescribing in National Health Service general dental practice in England. Br Dent J 188(10):554–558

    Article  Google Scholar 

  30. Patrick D, Marra F, George D, Chong M, O’Keefe J, Blondel-Hill E (2015) What accounts for a large increase in antibiotic prescribing by dentists? Open Forum Infect Dis 2(Suppl 1):156

    Article  Google Scholar 

  31. Cope AL, Barnes E, Howells EP, Rockey AM, Karki AJ, Wilson MJ et al (2016) Antimicrobial prescribing by dentists in Wales, UK: findings of the first cycle of a clinical audit. Br Dent J 221(1):25–30

    Article  Google Scholar 

  32. Salako NO, Rotimi VO, Adib SM, Al-Mutawa S (2004) Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait. J Dent 32(7):503–509

    Article  Google Scholar 

  33. Al-Haroni M, Skaug N (2006) Knowledge of prescribing antimicrobials among Yemeni general dentists. Acta Odontol Scand 64(5):274–280

    Article  Google Scholar 

  34. Lewis M a. O 2008 Why we must reduce dental prescription of antibiotics: European Union Antibiotic Awareness Day Br Dent J 205 10 537 8

  35. Kapoor D, Gill S, Singh A, Kaur I, Kapoor P (2014) Oral hygiene awareness and practice amongst patients visiting the Department of Periodontology at a Dental College and Hospital in North India. Indian J Dent 5(2):64–68

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Faculty of Public Health, Lebanese University, Fanar, Lebanon

    Nadine Chehabeddine, Nathalie Lahoud, Rouba K. Zeidan, Mira Hleyhel & Nadine Saleh

  2. Center for Research in Public Health, Faculty of Public Health, Pharmacoepidemiology Surveillance Unit, CERIPH, Lebanese University, Fanar, Lebanon

    Nathalie Lahoud, Rouba K. Zeidan & Nadine Saleh

  3. INSPECT-LB, Faculty of Public Health, Institut National de Sante Publique, Epidemiologie Clinique Et Toxicologie, Lebanese University, Fanar, Lebanon

    Nathalie Lahoud, Rouba K. Zeidan & Nadine Saleh

  4. Faculty of Pharmacy, Lebanese University, Hadat, Lebanon

    Nathalie Lahoud & Nadine Saleh

  5. Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon

    Ziad E. F. Noujeim

Authors
  1. Nadine Chehabeddine
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  2. Nathalie Lahoud
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  3. Ziad E. F. Noujeim
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  4. Rouba K. Zeidan
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  5. Mira Hleyhel
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  6. Nadine Saleh
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Contributions

The first, second, and last authors contributed to the study design and conception, interpretation of data, and critical revision. Moreover, the first author contributed to data collection, data entry, data analysis, and the drafting of the manuscript. The intervention was prepared by the first and the last authors. The other authors contributed to critical revision. All authors gave final approval for the publication of the manuscript.

Corresponding author

Correspondence to Nadine Chehabeddine.

Ethics declarations

Ethical approval

The ethics committee at the Lebanese University renounced the requirement for approval since the individuals’ confidentiality was respected.

Conflict of interest

The authors declare no competing interests.

Informed consent

Verbal consent was obtained from each dentist who participated in this study. Besides, confidentiality for patients and dentists was ensured by anonymity through the coding of the identification data.

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Appendix

Appendix

Table 7 Conformity of indication between both groups regarding the medical conditions that led to antibiotic prescription before and after the intervention period for prophylactic or curative purposes
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Chehabeddine, N., Lahoud, N., Noujeim, Z. .F. et al. Effect of an educational intervention among Lebanese dentists on antibiotic prescribing: a randomized controlled study. Clin Oral Invest 26, 4857–4869 (2022). https://doi.org/10.1007/s00784-022-04453-6

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  • DOI: https://doi.org/10.1007/s00784-022-04453-6

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