The Big Picture on Antibiotic Resistance

Objectives: According to a recent report from the WHO antibiotic resistance is “one of the biggest threats to global health, food security and development today”. It is estimated that the dental profession contributes around 10 % on the number of annual prescriptions with a large percentage challenged for adequacy in recent studies .The objective of the presentation is to ascertain those components that contribute to the antibiotic resistance related to oral health practices , analyze the current evidence for quality and identify knowledge gaps.
Methods:
Pubmed was searched for the last 5 years and the quality of the studies was assessed.
Results: The search revealed very limited number of guidelines on the prevention of endocarditis and joint infections and multiple recommendations from a number of organizations. More than 30 systematic reviews indexed in Pubmed over the last 5 years, cover the following topics, ordered from most to least frequent based on the number of studies : the use of antibiotics during dental implants; nonsurgical periodontal treatment; third molar extractions; apical periodontitis and irreversible pulpitis.
Numerous individual studies reporting on antibiotic prescribing patterns and knowledge attitudes and practices appeared over the last 2 years . During the same period ,a small number of clinical trials studied adverse drug reactions and effectiveness of antibiotics on oral infections.
Other key components to antibiotic resistance were addressed in a limited number of studies : self-medication , antimicrobial stewardship programs and interventions to reduce antibiotic prescriptions
Conclusions: For the most part the current evidence is limited and sometimes conflicting.
Implementation and adoption are the least studied issues.
The extend of patient centered topics like access to medications without prescriptions, compliance and individuals perception for requesting antibiotics are not known.
Also unknown is the role of the pharmaceutical industry .