Objective To study the use of prophylactic antibiotics by general dental practitioners. Design A postal questionnaire of National Health Service (NHS) general dental practitioners in ten English Health Authorities. Su...
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Objective To study the use of prophylactic antibiotics by general dental practitioners. Design A postal questionnaire of National Health Service (NHS) general dental practitioners in ten English Health Authorities. Subjects General dental practitioners (GDPs) (1544) contracted to provide NHS treatment in the Health Authorities of Liverpool, Wirral, Oxfordshire, Buckinghamshire, Nottingham, North Nottinghamshire, Sheffield, Newcastle, Northumberland and North Tyneside. Main outcome measures The questionnaires were analysed and the responses to each question expressed as absolute frequencies. Results Responses to the questionnaires were received from 929 (60.1%) practitioners. Over 40% of general dental practitioners would prescribe prophylactic antibiotics for patients with no relevant medical history for minor oral surgery to prevent postoperative infection. Amoxicillin was the predominant choice of antibiotic in this situation. Between 15-67% of GDPs failed to prescribe prophylactic antibiotics for at risk medically compromised patients. GDPs also prescribed for patients with a medical history not known to be at risk from dental procedures, Over 50% of GDPs however, would seek specialist advice about prophylaxis if they were unsure of the indications and over 90% of GDPs indicated they would use the current recommended regime for antibiotic prophylaxis for patients at risk of infective endocarditis. Conclusions The evidence from this study suggests that a significant number of the practitioners surveyed prescribe prophylactic antibiotics inappropriately, both for surgical procedures and for patients at risk from endocarditis. There is also evidence that practitioners prescribe antibiotic prophylaxis for clinical procedures and medical conditions for which there is little evidence. The results suggest that there is a need for the development of guidelines for practitioners on the appropriate prophylactic use of antibiotics.
The objectives of this cross-sectional study were to determine the frequency of HIV infection among dental patients attending the three dental facilities at Muhimbili Medical Centre (MMC) in Dar-es-Salaam, Tanzania, a...
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The objectives of this cross-sectional study were to determine the frequency of HIV infection among dental patients attending the three dental facilities at Muhimbili Medical Centre (MMC) in Dar-es-Salaam, Tanzania, and to compare the dental treatment demands and needs of the patients found to be HIV-infected with those of their HIV-seronegative counterparts. The facilities were;the dental outpatient department (DOPD) clinic, the dental minor surgery department, and the dental ward. This study which was conducted between March and April, 1996 enrolled a total of 460 patients. The investigations involved detection of anti-HIV IgG antibodies in saliva, examination of oral and peri-oral tissues, and assessment of dental and periodontal status. The overall HIV frequency among the dental patients was 10.9 per cent. The frequencies of HIV infection among patients attending the dental OPD clinic, minor surgery, and those admitted in the dental ward were 9.4 per cent, 26.3 per cent, and 25.0 per cent, respectively. The dental treatment demands and needs of HIV-seropositive patients were not different from that of HIV-seronegative patients. The high frequency of HIV infection calls for institution of infection control measures in the dental clinics. However, such measures need to be tailored for the poor countries, with potentially high frequency of HIV infection and minimal resources, in order to make them relevant.
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