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Antibiotics
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Antibiotic Prescribing in Primary Dental Care
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Antibiotic Prescribing in Primary Dental Care

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 10053

Special Issue Editor

Dr. Kristina Peros

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Guest Editor
Department of Pharmacology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Interests: antibiotic stewardship; oral health; oral microbiome; saliva
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prescribing of antibiotics in primary dental care is a daily procedure that is well regulated by evidence-based guidelines. However, the continuous development of bacterial resistance worldwide necessitates greater efforts to improve the patterns of antibiotic prescribing by clinicians, including dentists. Primary dental care covers common oral cavity infections, as well as odontogenic and periodontal infections, requiring systemic antimicrobial therapy in addition to mechanical dental treatment.

Finding the ideal balance between indications for systemic antibiotic therapy in odontogenic infection (such as acute apical abscess with systemic involvement, the onset of a severe or spreading infection, osteomyelitis, the replantation of avulsed permanent teeth, or medically compromised patients) and the rationalization of antibiotic prescribing, using the most appropriate drug at the lowest dose necessary to obtain the best effect in the shortest period of time and at a reasonable cost, is of major interest for public health.

This Special Issue aims to provide an up-to-date insight into clinical questions concerning the prescribing of antibiotics in primary dental care, and to address antibiotic stewardship in dentistry. Particular consideration will be to given to original research, reviews, and short communications discussing more precise indications for the prescribing of antibiotics in dentistry, including laboratory and clinical diagnosis, therapeutic perspectives, rational prescribing, and the public health approach.

Dr. Kristina Peros
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • primary dental care
  • antibiotic prescribing
  • rational drug prescribing
  • antibiotic stewardship

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Related Special Issue

Published Papers (7 papers)

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Research

16 pages, 218 KiB  
Article
Antibiotics Use for Dental or Oral Cavity Infections in Pediatric Dentistry: Knowledge and Prescribing Practices Between Italian Dentists
by Martina Barone, Michele Basilicata, Giovanni Bruno, Christian Bacci, Patrizio Bollero, Raffaella Docimo, Antonio Gracco, Alberto De Stefani and Filippo Cavallari
Antibiotics 2025, 14(4), 357; https://doi.org/10.3390/antibiotics14040357 - 31 Mar 2025
Viewed by 354
Abstract
In pediatric dentistry, antibiotics are currently prescribed for both therapeutic and prophylactic purposes. Antibiotic therapy can be prescribed for the treatment of diffuse dental or oral cavity infections, always as a complement to the most suitable dental procedure for the specific case. The [...] Read more.
In pediatric dentistry, antibiotics are currently prescribed for both therapeutic and prophylactic purposes. Antibiotic therapy can be prescribed for the treatment of diffuse dental or oral cavity infections, always as a complement to the most suitable dental procedure for the specific case. The aim of this study was to investigate the knowledge regarding the use and prescribing practices of antibiotics in pediatric patients in a sample of Italian dentists by using an anonymous and telematic questionnaire. Methods: A specially prepared questionnaire was electronically transmitted to a cohort of Italian dentists. The questionnaire consisted of two parts: demographic information and general knowledge of antibiotic prescription in pediatric dentistry. The statistical analysis of the obtained data was performed. Results: The study sample consisted of 242 Italian dentists. Poor statistically significant differences emerged between specialists in Pediatric Dentistry and dentists without specialization or specialists in other branches, as well as between dentists who, in their clinical activity, mainly treat children/adolescents or adults. For the complementary treatment of dental or oral cavity infections, Amoxicillin was the antibiotic indicated as the first choice for pediatric patients with no allergy to penicillins by most of the sample, while more than 20% of dentists would prescribe Clindamycin in patients with an allergy to penicillin. The knowledge regarding the dosage of administration of the chosen antibiotic appeared not to be sufficient. Conclusions: An improvement in the knowledge of the Guidelines in Pediatric Dentistry appeared necessary regarding the posology of the antibiotic of choice. More information about the adverse effects of Clindamycin is needed. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
13 pages, 396 KiB  
Article
Antibiotic Prophylaxis Prescribing Practices for Dental Implant Placement in Croatia: A Questionnaire-Based Cross-Sectional Study
by Mare Ković, Ajka Pribisalić, Joško Viskić, Jure Martinić, Josipa Grubišić, Ante Vardić and Tina Poklepović Peričić
Antibiotics 2025, 14(1), 47; https://doi.org/10.3390/antibiotics14010047 - 8 Jan 2025
Cited by 1 | Viewed by 1145
Abstract
Background/Objectives: This study aimed to explore antibiotic prescribing practices for dental implant placement in Croatia. Methods: We conducted a cross-sectional questionnaire-based study including dentists in Croatia who perform dental implant therapy. The questionnaire assessed the dentists’ age, working experience, education level, [...] Read more.
Background/Objectives: This study aimed to explore antibiotic prescribing practices for dental implant placement in Croatia. Methods: We conducted a cross-sectional questionnaire-based study including dentists in Croatia who perform dental implant therapy. The questionnaire assessed the dentists’ age, working experience, education level, and whether they use antibiotics for dental implant placement, as well as the choice of antibiotics, timing, and reasons for antibiotics use. We used snowball and convenient sampling methods for recruiting dentists. Categorical data were described as absolute numbers and percentages. Differences in the use of antibiotics for specific health conditions were analyzed using Chi-Square, with p < 0.05. Results: Overall, 74 dentists completed the survey. The dentists used antibiotics either before and after (N = 37, 48.7%), before (N = 21; 27.6%), or after dental implant placement (N = 17, 22.4%). Most used Amoxicillin (N = 47, 61.8%), or Amoxicillin–clavulanic acid (N = 22, 28.9%). Almost all dentists used antibiotics in patients with artificial heart valves (N = 73, 97.3%) and a history of infective endocarditis (N = 74, 98.7%). Also, the dentists reported using antibiotics in patients with artificial joints (N = 52, 69.3%), diabetes (N = 48, 64%), HIV (N = 51, 34.2%), or those on antiresorptive drugs (N = 46, 61.3%), with 17 dentists (22.7%) prescribing antibiotics to all (p < 0.001). The main reasons for antibiotic prophylaxis were preventing complications at the implant site (N = 56; 73.7%) and reducing the early implant failure rate (N = 32; 42.1%). Around one-third of the dentists (34.2%) used antibiotics for their own safety. Conclusions: Croatian dentists may be overprescribing antibiotics during dental implant placement. Clear recommendations concerning antibiotic prophylaxis for dental implant therapy are needed to make well-informed clinical decisions. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
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17 pages, 678 KiB  
Article
Antibiotics Knowledge and Prescription Patterns Among Dental Practitioners in Croatia, Bosnia and Herzegovina, and Serbia: A Comparative E-Survey with a Focus on Medically Healthy and Compromised Patients
by Marija Badrov, Danijela Marovic and Antonija Tadin
Antibiotics 2024, 13(11), 1061; https://doi.org/10.3390/antibiotics13111061 - 8 Nov 2024
Viewed by 1310
Abstract
Background: The non-specific prescription of antibiotics, especially in dentistry, contributes to the global problem of antimicrobial resistance and highlights the need for education on the proper use and serious consequences of overprescribing these drugs. The main objective of this study is to assess [...] Read more.
Background: The non-specific prescription of antibiotics, especially in dentistry, contributes to the global problem of antimicrobial resistance and highlights the need for education on the proper use and serious consequences of overprescribing these drugs. The main objective of this study is to assess and evaluate antibiotic knowledge and prescribing patterns in dental practice in Croatia, Bosnia and Herzegovina, and Serbia, focusing on understanding the rationale for prescribing, adherence to evidence-based guidelines, and dentists’ awareness of antibiotic resistance. Methods: A total of 795 dentists participated in this electronic cross-sectional survey (Croatia N = 336, Bosnia and Herzegovina N = 176, and Serbia N = 283). The study utilized a self-structured questionnaire to collect data on various aspects of antibiotic use, including knowledge, prescribing practices, awareness of guidelines, and demographic and professional information about dentists. Data analysis included the Mann–Whitney test, the Kruskal–Wallis test with post hoc analysis, and chi-square tests, with statistical significance set at p < 0.05. Results: The overall score for the participants’ knowledge of antibiotics was 6.40 ± 1.40 out of a maximum of eight points, which indicates a generally good level of knowledge among dentists. Factors such as gender, specialty, and practice location significantly influenced the level of knowledge (p < 0.05). However, actual prescribing practice was a cause for concern. Only 66.1% of Croatian dentists felt they had received adequate training during their studies, and even fewer in Serbia (48.4%) and Bosnia (46.6%). It is noteworthy that 9.7% of dentists in Bosnia and Herzegovina prescribe antibiotics at the request of patients, while 22.3% of Croatian and 25.4% of Serbian dentists do so. Many dentists prescribe no or only one antibiotic per week. In addition, 50.9% of Croatian dentists reported adverse effects related to the use of antibiotics, while only 31.3% of Bosnian and 33.6% of Serbian dentists reported similar experiences. Conclusions: While the study results indicate that dentists in the region generally possess good knowledge of antibiotic use, there are significant discrepancies between this knowledge and actual prescribing practices. This highlights the need for enhanced educational programs and awareness initiatives focused on proper antibiotic guidelines to improve prescribing behaviors. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
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9 pages, 222 KiB  
Article
Antibiotic Prescribing Habits in Endodontics among Dentists in the Federation of Bosnia and Herzegovina—A Questionnaire-Based Study
by Matea Galić, Ivana Miletić, Tina Poklepović Peričić, Valentina Rajić, Nikolina Nika Većek Jurčević, Ajka Pribisalić and Ivana Medvedec Mikić
Antibiotics 2024, 13(9), 876; https://doi.org/10.3390/antibiotics13090876 - 12 Sep 2024
Cited by 2 | Viewed by 1697
Abstract
Backgrounds: Antibiotics are used in endodontic treatment to control acute odontogenic infection and for prophylactic purposes. This study aimed to investigate the knowledge of dentists from the Federation of Bosnia and Herzegovina about the choice and the routes of antibiotic administration in endodontics. [...] Read more.
Backgrounds: Antibiotics are used in endodontic treatment to control acute odontogenic infection and for prophylactic purposes. This study aimed to investigate the knowledge of dentists from the Federation of Bosnia and Herzegovina about the choice and the routes of antibiotic administration in endodontics. Methods: This cross-sectional study involved dentists in Federation of Bosnia and Herzegovina health institutions. The Dental Chamber sent a twelve-question survey to members’ email addresses. They were asked about the type, dosage, indications, and side effects of antibiotics used in endodontics. The obtained data were screened and analyzed. Results: A total of 180 questionnaires were filled out. The most commonly prescribed antibiotic was amoxicillin with clavulanic acid. Pulp necrosis with symptomatic apical periodontitis, swelling, and moderately severe symptoms were the main indications for the therapeutic use of antibiotics. Amoxicillin, administered orally at 2 g 1 h before endodontic surgery for patients with bacterial endocarditis, was mostly indicated for the prophylactic use of antibiotics. Conclusions: Based on the results of this study, we can conclude that dentists from the Federation of Bosnia and Herzegovina have limited knowledge regarding antibiotic use in endodontics. Educational activities and campaigns are necessary to raise awareness about antibiotics in dental medicine in the Federation of Bosnia and Herzegovina. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
14 pages, 1202 KiB  
Article
Antibiotic Prescribing Trends in Dentistry during Ten Years’ Period—Croatian National Study
by Ivana Šutej, Krešimir Bašić, Sanja Šegović and Kristina Peroš
Antibiotics 2024, 13(9), 873; https://doi.org/10.3390/antibiotics13090873 - 12 Sep 2024
Cited by 3 | Viewed by 1254
Abstract
Prescribing antibiotics is a regular part of daily dental practice. Antibiotics have a significant but a limited role in general dental practice due to the threat of emergence of antimicrobial resistance (AMR). As such, the aim of this study was to assess prescribing [...] Read more.
Prescribing antibiotics is a regular part of daily dental practice. Antibiotics have a significant but a limited role in general dental practice due to the threat of emergence of antimicrobial resistance (AMR). As such, the aim of this study was to assess prescribing trends in dental antibiotics use from 2014–2023 in Croatia. Data on antibiotic prescribing practices for this study were provided by the Croatian Health Insurance Fund. The analysis included the number of prescriptions, packages, cost, and the World Health Organization’s defined daily dose per 1000 inhabitants (DID) per day as an objective utilization for comparison. Over the 10-year period, dentists in Croatia prescribed an annual average of 357,875 antibiotic prescriptions, representing an annual average of 78.7% of all dental prescriptions. The most commonly prescribed antibiotic was the combination of amoxicillin and the beta-lactamase inhibitor clavulanic acid, which made up 58.54% of antibiotics and 46.1% of all dental prescriptions. This was followed by amoxicillin (12.61%), clindamycin (12.58%), and metronidazole (9.96%). The trend showed two discontinuations, the first for the pandemic years, and the second caused by disruption in amoxicillin production. The rise in the use of broad-spectrum antibiotics needs to be addressed and regulated to ensure patients and dentists understand that antibiotics are not a substitute for dental treatment. Dentists should always begin treatment with narrow-spectrum antibiotics regardless of possible exceptional circumstances. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
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15 pages, 3653 KiB  
Article
Patterns of Antibiotic Prescription in Endodontic Therapy in the Republic of Croatia
by Josipa Sović, Sanja Šegović, Božidar Pavelić, Ivona Bago, Ivana Šutej and Ivan Tomašić
Antibiotics 2024, 13(7), 645; https://doi.org/10.3390/antibiotics13070645 - 12 Jul 2024
Cited by 5 | Viewed by 1291
Abstract
In response to the global trend of decreasing antibiotic usage, this study aimed to evaluate the nature and frequency of antibiotic prescriptions in conjunction with endodontic therapy in Croatia and to assess the attitudes of Croatian dental practitioners towards the endodontic treatment of [...] Read more.
In response to the global trend of decreasing antibiotic usage, this study aimed to evaluate the nature and frequency of antibiotic prescriptions in conjunction with endodontic therapy in Croatia and to assess the attitudes of Croatian dental practitioners towards the endodontic treatment of patients susceptible to bacterial endocarditis. A survey questionnaire was sent to all dental practitioners in Croatia, achieving a response rate of 27%. The most frequently prescribed antibiotic was penicillin with clavulanic acid (63.4%), while standalone penicillin was less prevalent (18.6%). For patients exhibiting penicillin allergies, 90% of respondents indicated clindamycin as their preferred alternative. Antibiotics were mostly prescribed for localized acute apical abscesses without fever, followed by prophylaxis for infectious endocarditis and cellulitis. Only 1.3% of the respondents reported frequent antibiotic prescriptions without accompanying local treatment. While a substantial proportion of surveyed practitioners professed familiarity with the latest guidelines for antibiotic prophylaxis, their choice of antibiotics did not consistently reflect this claim. Most respondents conducted endodontic procedures on patients at risk of bacterial endocarditis. The findings highlight a need for targeted continuing education for dental practitioners in the Republic of Croatia, ensuring their practices align with current guidelines and global trends in antibiotic prescription. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
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9 pages, 211 KiB  
Article
Antibiotic-Prescribing Habits in Dentistry: A Questionnaire-Based Study
by Luca Sbricoli, Giulio Grisolia, Edoardo Stellini, Christian Bacci, Marco Annunziata and Eriberto Bressan
Antibiotics 2024, 13(2), 189; https://doi.org/10.3390/antibiotics13020189 - 16 Feb 2024
Cited by 2 | Viewed by 2241
Abstract
The problem of antibiotic resistance is becoming increasingly serious worldwide due to uncontrolled prescription. Dentists are among the groups that prescribe the most antibiotics, often to delay urgent treatment. The purpose of the present study is to investigate the prescribing protocols adopted by [...] Read more.
The problem of antibiotic resistance is becoming increasingly serious worldwide due to uncontrolled prescription. Dentists are among the groups that prescribe the most antibiotics, often to delay urgent treatment. The purpose of the present study is to investigate the prescribing protocols adopted by dentists for prophylaxis and antibiotic therapy in major clinical surgical indications. Methods: A ten-question survey was administered to a group of Italian dentists. The participants were asked about their preferences for antibiotic administration for the prevention of infective endocarditis, the administration of antibiotics to patients allergic to penicillin, the insertion of implants, and the extraction of third molars. The retrieved data were screened and analyzed. Results: A total of 298 surveys were filled out. The most-prescribed antibiotic was amoxicillin or amoxicillin with clavulanic acid or macrolides for allergic patients. The administration of two grams of amoxicillin one hour before surgery was the most widely used prescriptive protocol for prophylaxis. International guidelines on antibiotic prophylaxis for infective endocarditis were only partially followed. The most heterogeneous results emerged for prophylaxis associated with dental implants or provided prior to surgical third-molar extraction. Conclusions: The present study shows widespread antibiotic prescriptive heterogeneity among the sample of dentists analyzed, especially in conditions where international guidelines are lacking. An evidence-based consensus on prescriptive modalities in dentistry would be desirable in the near future. Full article
(This article belongs to the Special Issue Antibiotic Prescribing in Primary Dental Care)
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