Prophylactic Antibiotic Prescribing Patterns Among Dental Practitioners In Malaysia

Introduction: The empiric use of antibiotic prophylaxis for dental procedures is well established. Misuse of antibiotics is unacceptable and dentists must prescribe antibiotics judiciously to avoid their adverse effects. Objectives: To determine the prophylactic antibiotic prescribing patterns of dentists and their prescribing habits regarding cardiac conditions and dental procedures for patients predisposed to infective endocarditis (I.E.). Method: A questionnaire was utilized to determine the prophylactic antibiotic prescribing patterns for patients at risk of I.E., determine the prescribing habits for some cardiac conditions and the antibiotic cover for dental procedures for patients predisposed to I.E., to identify compliance to American Heart Association Guidelines (AHAG) 2008 and to evaluate statistical significance among demographic parameters. Results: 217 (30.7%) responses obtained showed that there was a large variation in antibiotic prescriptions patterns. 30% did not follow AHAG. And there was confusion as to which cardiac conditions required prophylaxis and which particular dental procedures. 12% prescribed antibiotics for old myocardial infarction and 70% prescribed antibiotics for bleeding from trauma to lip or oral mucosa. The results also revealed that there was uncertainty in prescribing antibiotics for some cardiac conditions among dentists who attended courses on application of antibiotics in dental practice, they prescribed antibiotics unnecessarily when performing endodontic obturation (27.8%) or taking oral radiograph (19.4%) for patients at risk of I.E. Conclusions: There is a need to update dentists' knowledge with recent antibiotic guidelines and more effective intervention to reduce the unnecessary prophylaxis use of antibiotics.