Abstract

Objective: The rate of endodontic infections occurrence is very high worldwide and the use of antibiotics to overcome these infections is a common dental practice. The aim of this study is to determine the clinically relevant situations where an antibiotic cover is needed and focuses on the prescription patterns of endodontic postgraduate trainees.

Material and methods: A cross sectional study was performed in which data was collected from five different dental institutes offering post-graduation in endodontics all over Karachi, Pakistan. A total of 100 questionnaires were distributed out of which only 82 surveys came back with responses. The study was conducted for a period of one month from August 2018- September 2018. The data collected was analyzed by SPSS version 21.

Results: A combination of amoxicillin with Clavulanic acid was the first choice of antibiotic in patients with no known allergies to penicillin (40.6%), whereas erythromycin was the first choice of antibiotic in patients having allergic reactions to penicillin (39.3%). The duration of treatment on average was 5 days. In clinical situations of irreversible pulpitis, with or without apical periodontitis, 74.3% and 67% of the respondents prescribed antibiotics. 78 % of respondents have prescribed antibiotics in cases of necrotic pulp with acute apical periodontitis.

Conclusion: The highest rate of antibiotic prescription was noted in cases of necrotic pulp having severe symptoms and extra oral swelling, whereas cases having necrotic pulp, mild symptoms and associated sinus tract was the second highest condition. The most preferred combination of antibiotics was amoxicillin with Clavulanic acid for patients non-allergic to penicillin, and for patients allergic to penicillin, Erythromycin was most commonly prescribed.

Key words: Antibiotics, Odontogenic infections, Endodontics, Microbial resistance