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      Antibiotic prescription: An oral physician's point of view

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          Abstract

          Background:

          Antibiotics are important in the management and prophylaxis of infections in patients at a risk of experiencing microbial disease. Uses of systemic antibiotics in dentistry are limited since management of acute dental conditions is primarily based upon extraction of teeth or extirpation of the pulp. However, the literature provides evidence of inappropriate prescribing practices by practitioners, due to a number of factors from inadequate knowledge to social factors.

          Aim:

          The aim was to assess the therapeutic prescription of antibiotics in the dental office.

          Materials and Methods:

          In the current study, 42 faculty members of two dental colleges in the same vicinity were included. A questionnaire was drafted and sent to the dentists to collect data pertaining to the conditions in which antibiotics were prescribed and most commonly prescribed antibiotic.

          Results:

          During the study period, 42 faculty members from various departments in the institutes were surveyed, of which 41 questionnaires were completely filled. Amoxicillin was the most commonly prescribed antibiotic followed by other amoxicillin combinations; Metronidazole was most widely prescribed antibiotic for anaerobic infections.

          Conclusion:

          We have entered an era where cures may be few due to increasing microbial resistance. The biggest force for change will be if all practicing dentists looked at their prescribing and made it more rational.

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          Most cited references15

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          Antibiotic prescribing practices by dentists: a review

          Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, due to a number of factors ranging from inadequate knowledge to social factors. Here we review studies that investigated the pattern of antibiotic use by dentists worldwide. The main defects in the knowledge of antibiotic prescribing are outlined. The main conclusion is that, unfortunately, the prescribing practices of dentists are inadequate and this is manifested by over-prescribing. Recommendations to improve antibiotic prescribing practices are presented in an attempt to curb the increasing incidence of antibiotic resistance and other side effects of antibiotic abuse.
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            Why we must reduce dental prescription of antibiotics: European Union Antibiotic Awareness Day.

            Cara Lewis (2008)
            The prescription of antibiotics in dentistry is relatively small but nonetheless significant. With the emergence of bacterial species resistant to antibiotics there is a need to become vigilant about their prescription and with this, an urgent requirement for both professional and public understanding of the appropriate use of this life-saving component of treatment.
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              The tide of antimicrobial resistance and selection.

              The cumulative ecological damage, both to the individual patient and to patient populations, secondary to antibiotic prescribing is increasingly recognised. The impact of antibiotics on pathogens and normal flora should be a criterion for antimicrobial selection. Measures to reduce the use of third-generation cephalosporins and fluoroquinolones should be considered. Increased reliance on carbapenems may accelerate the emergence of extremely resistant isolates, and these antimicrobials should be restricted to key scenarios. There is a clear need for new agents with novel modes of action and low ecological damage potential to treat nosocomial infections. Tigecycline has a spectrum of activity that theoretically may reduce the selection pressure for key nosocomial pathogens, and represents an alternative to carbapenems. Further studies are needed to confirm this potentially low selection pressure.
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                Author and article information

                Journal
                J Pharm Bioallied Sci
                J Pharm Bioallied Sci
                JPBS
                Journal of Pharmacy & Bioallied Sciences
                Medknow Publications & Media Pvt Ltd (India )
                0976-4879
                0975-7406
                Apr-Jun 2015
                : 7
                : 2
                : 116-120
                Affiliations
                [1]Professor and Head, Department of Oral Medicine and Radiology, S. M. B. T. Dental College, Hospital and PG Research Institute, Sangamner, Maharashtra, India
                [1 ]Post Graduate Student, Department of Oral Medicine and Radiology, S. M. B. T. Dental College, Hospital and PG Research Institute, Sangamner, Maharashtra, India
                [2 ]Pro Vice Chancellor, Maharashtra University of Health Sciences, Nashik, India
                [3 ]Reader, Department of Oral Medicine and Radiology, S. M. B. T. Dental College, Hospital and PG Research Institute, Sangamner, Maharashtra, India
                [4 ]Consultant Endodontis, Allur Hospital, Mumbai, India
                [5 ]Esthetic Dental Surgeon, Nashik, India
                Author notes
                Address for correspondence: Dr. Mahendra R. Patait, E-mail: drmahendracbctguide@ 123456gmail.com
                Article
                JPBS-7-116
                10.4103/0975-7406.154434
                4399009
                57318a8b-0787-448d-9e7e-1036ecf94cd6
                Copyright: © Journal of Pharmacy and Bioallied Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 March 2014
                : 10 August 2014
                : 20 October 2014
                Categories
                Original Article

                Pharmacology & Pharmaceutical medicine
                antibiotics,dental practice,microbial disease recommended practice

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