Antibiotic prescription in emergency dental service in Zagreb, Croatia

Objectives: To analyze the antibiotic prescription in emergency dental service in the city of Zagreb according to several factors: the type of antibiotic, diagnosis, time of the visit, demographic characteristics of the patient and prescription habits of individual doctors.
Methods: The patients personal data, established diagnoses, performed therapies and prescribed antibiotics were collected from electronic medical records during the period of 1.5 years. They were stored in a computer database and presented through descriptive statistics. The statistical analysis was conducted using the chi-square test and z-test with Bonferroni correction at the significance level of 0.05.

Results: Antibiotics were prescribed in 10,188 of the total 20,879 analyzed patient visits (48.8%). Most commonly prescribed antibiotics belonged to the penicillin group containing clavulanic acid (70.5%), followed by clindamycin (13.0%) and combinations of penicillin and metronidazole (7.2%). The most common reasons for visit were periodontitis periapicalis chronica, abcessus periapicalis and pulpitis (28.4%, 21.9% and 20.5% of total number of visits, respectively). Antibiotics were most frequently prescribed for abcessus periapicalis, dentition difficilis and radix relicta (79.8%, 64.3% and 63.3% of cases, respectively). Antibiotic prescription was more frequent during weekends and holidays than during working days (55.6% vs. 33.2% of the total number of patients, respectively). The percentage of patients prescribed with antibiotics increased from the age of 1 to the age of 75 (29.4-65.6%), after which it decreased. A significant discrepancy in the percentage of patients prescribed with antibiotics was noted among different doctors and it ranged from 15.0-72.1%. It was also observed that doctors' personal preferences greatly affected the frequency and type of the prescribed antibiotics.
Conclusions:
This study indicates a very high frequency of antibiotic prescriptions in emergency dental offices, especially during weekends and holidays.