Knowledge and Attitudes Towards Antibiotic Prescribing Among Dentists in Sudan

Ramadan, AbdelRahman Murtada; Rikaby, Omer AbdelKariem Al; Abu-Hammad, Osama Abdalla; Dar-Odeh, Najla Saeed

doi:10.4034/PBOCI.2019.191.17

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 19 • 2019 • https://doi.org/10.4034/PBOCI.2019.191.17 copy

Knowledge and Attitudes Towards Antibiotic Prescribing Among Dentists in Sudan

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate antibiotic prescribing practices of dentists working in a major teaching hospital in Sudan, and to assess the need for establishing education programmes to enhance dentists’ awareness of antibiotic use.

Material and Methods:

A cross-sectional study was carried out by distributing an anonymous self-administered questionnaire to a convenience sample of dental practitioners at major teaching hospital in Khartoum/Sudan. The questionnaire investigated knowledge and attitudes of participants in relation to antibiotic prescribing in dental practice.

Results:

One hundred out of 135 dental practitioners working at the hospital participated in the survey with 48 males and 52 females. Most of the participants (N=44) did not specify their preferable drug reference, while 32 participants specified British National Formulary, and the practice was significantly associated with a higher professional rank (p<0.001). Metronidazole was the most frequently cited antibiotic for dentofacial infections (N=73) and Acute Necrotizing Ulcerative Gingivitis (N=56), while amoxicillin was the most frequently cited antibiotic for dento-alveolar infections and infective endocarditis prophylaxis (N=88 and N=47, respectively).

Conclusion:

Undergraduate, as well as postgraduate courses,, are required in Sudan to provide up-to-date orientation on antibiotic use, and to increase awareness of dentists about antibiotic prescribing.

Keywords:
Drug Prescriptions; Anti-Bacterial Agents; Focal Infection, Dental

Variables	N	BNF	Dental National Formulary	Other References	Senior Practitioners	p-value
Graduation Year
<2007	33	54.0%	15.2%	6.1%	24.2%	0.005
≥2007)	67	21.2%	13.6%	10.0%	54.5%
Professional Rank
Seniors	25	72.0%	12.0%	4%	12.0%	0.000
Juniors	75	18.9%	14.9%	10.8%	55.4%
Attendance of Antibiotic Activity
Yes	30	46.7%	13.3%	6.7%	33.3%	0.237
No	70	26.1%	14.5%	10.1%	49.3%
Gender
Male	48	40.4%	10.6%	8.5%	40.4%	0.423
Female	52	25.5%	17.6%	9.8%	47.1%

Antibiotics	Den-alv	Den-fac	ANUG	IE	Cumulative Antibiotic Use for All Conditions
Metronidazole	87	73	56	7	223
Amoxicillin	88	47	18	47	200
Amoxicillin-Clavulanic Acid	31	51	10	19	111
Clindamycin	12	9	4	5	30
Penicillin V	3	5	6	3	17
Erythromycin	8	3	1	0	12
Tetracycline	3	0	8	0	11
Cephalosporin III	7	1	1	0	9
Doxycycline	2	1	6	0	9
Ciprofloxacin	2	3	1	0	6
Azithromycin	0	3	1	0	4
Cephalexin	1	0	1	0	2
Ampicillin	1	0	1	0	2
Cephalosporin II	0	0	1	0	1

	Graduation Year		Professional Rank		Attendance of Antibiotics Courses		Gender
Participants' Decisions	<2007	≥2007	Seniors	Juniors	Yes	No	Male	Female
	%	%	%	%	%	%	%	%
Dental and Periodontal Abscess
Yes	97.0	92.5	96.0	93.3	100.0	91.4	93.6	94.2
No	3.0	7.5	4.0	6.7	0.0	8.6	6.4	5.8
p-value	0.380		0.627		0.098		0.898
Pericoronitis
Yes	84.8	73.1	72.0	78.7	70.0	80.0	78.7	75.0
No	15.2	26.9	28.0	21.3	30.0	20.0	21.3	25.0
p-value	0.191		0.493		0.276		0.661
Post Extraction / Surgical Procedure
Yes	75.8	68.7	72.0	70.7	76.7	68.6	68.1	75.0
No	24.2	31.3	28.0	29.3	23.3	31.4	31.9	25.0
p-value	0.462		0.899		0.414		0.446
Dry Socket
Yes	63.6	44.8	48.0	52.0	53.3	50.0	46.8	53.8%
No	36.4	55.2	52.0	48.0	46.7	50.0	53.2	46.2%
p-value	0.076		0.729		0.760		0.484
Patient in Pain
Yes	18.2	10.4	24.0	9.3	16.7	11.4	14.9	11.5
No	81.8	89.6	76.0	90.7	83.3	88.6	85.1	88.5
p-value	0.280		0.059		0.475		0.622
Chronic Periodontitis
Yes	48.5	32.8	48.0	34.7	46.7	34.3	48.9	28.8
No	51.5	67.2	52.0	65.3	53.3	65.7	51.1	71.2
p-value	0.130		0.234		0.242		0.040^* * Statistically significant;
Prophylaxis
Yes	87.9	79.1	84.0	81.3	93.3	77.1	87.2	76.9
No	12.1	20.9	16.0	18.7	6.7	22.9	12.8	23.1
p-value	0.283		0.764		0.053		0.184
Patient Expectation
Yes	9.1	9.1	8.0	6.7	3.3	8.6	6.4	7.7
No	90.9	90.9	92.0	93.3	96.7	91.4	93.6	92.3
p-value	0.565		0.821		0.347		0.800
Trauma
Yes	90.9	73.1	80.0	78.7	90.0	74.3	85.1	73.1
No	9.1	26.9	20.0	21.3	10.0	25.7	14.9	26.9
p-value	0.040^* * Statistically significant;		0.887		0.077		0.144
Do you follow any antibiotic prescription protocol?
Yes	37.5	25.4	45.8	24.0	43.3	23.2	29.8	29.4
No	62.5	74.6	54.2	76.0	56.7	76.8	70.2	70.6
p-value	0.215		0.041^* * Statistically significant;		0.043^* * Statistically significant;		0.968
Ask patient for history of antibiotic use?
Yes	100.0	93.8	100.0	94.5	96.7	95.6	100.0	92.0
No	0.0	6.2	0.0	5.5	3.3	4.4	0.0	8.0
p-value	0.146		0.232		0.804		0.048^* * Statistically significant;
Do you discuss the main side effects of antibiotic with your patients?
Yes	77.4	64.1	79.2	64.8	82.1	62.7	82.6	56.2
No	22.6	35.9	20.8	35.2	17.9	37.3	17.4	43.8
p-value	0.189		0.190		0.063		0.006^ Highly statistically significant; When percentages do not add to 100%, this is because of non responses.
Usually, after you drain, abscesses do you request an antibiotic sensitivity tests?
Yes	39.4	22.7	58.3	18.7	34.5	25.7	45.7	31.5
No	60.6	77.3	41.7	81.3	65.5	74.3	54.3	68.5
p-value	0.083		0.000^ Highly statistically significant; When percentages do not add to 100%, this is because of non responses.		0.378		0.000^ Highly statistically significant; When percentages do not add to 100%, this is because of non responses.
If you request an antibiotic sensitivity test do you prescribe any antibiotic before the test results?
Yes	66.7	82.1	52.0	85.3	23.3	17.1	61.7	90.4
No	33.3	11.9	48.0	9.3	3.3	4.3	34.0	5.8
p-value	0.019^* * Statistically significant;		0.000^ Highly statistically significant; When percentages do not add to 100%, this is because of non responses.		0.546		0.002^ Highly statistically significant; When percentages do not add to 100%, this is because of non responses.

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[1] Author to whom correspondence should be addressed: Professor Najla S. Dar-Odeh, College of Dentistry, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia. Phone: +00966 592231888. E-mail: najla_dar_odeh@yahoo.com.