Antibiotic Utilization in a Dental Teaching Hospital in Yogyakarta, Indonesia
Science Journal of Clinical Medicine
Volume 3, Issue 3, May 2014, Pages: 37-42
Received: May 16, 2014; Accepted: May 29, 2014; Published: May 30, 2014
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Authors
Mayu Winnie Rachmawati, Department of Drug Management and Policy, Graduate School of Natural Science and Technology, Kanazawa University, Japan
Naoko YOSHIDA, Department of Drug Management and Policy, Graduate School of Natural Science and Technology, Kanazawa University, Japan
Hirohito TSUBOI, Department of Drug Management and Policy, Graduate School of Natural Science and Technology, Kanazawa University, Japan
Kazuko KIMURA, Department of Drug Management and Policy, Graduate School of Natural Science and Technology, Kanazawa University, Japan
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Abstract
Background: Various antibiotics are prescribed by dental practitioners to treat odontogenic infections. However, there has been no comprehensive study of antibiotics use in a dental teaching hospital in a developing country using World Health Organization (WHO) dose measurement units. Objective: This study was designed to evaluate the use of antibiotics among dental outpatients at a dental teaching hospital in Yogyakarta, Indonesia. Methods: A cross-sectional study of outpatients’ medical records was carried out in order to identify oral antibiotics administered during January-December 2011. Prescriptions that included antibiotics (N=2024) were separated from total prescriptions collected from medical records. The source and type of antibiotics prescribed and the diagnoses were recorded. Anatomical Therapeutic Chemical classification and Defined Daily Dosage (DDD) measurement units were assigned, and the information was compiled, coded, analyzed in accordance with WHO guidelines. Results: Thirteen different antibiotics were prescribed and all were administered to patients. Antibiotics were frequently prescribed contrary to generally accepted criteria and there was wide variation in prescribing. The most commonly prescribed antibiotic was amoxicillin (78.8%), followed by clindamycin (9.0%) and metronidazole (5.0%). The dental diagnosis most frequently reported was pulp gangrene (26.7%), followed by pulp necrosis (8.8%) and impaction-related problems (6.4%). There was a marked increase in total antibiotics use expressed in defined daily dose (DDD) per 1000 patient visit per month during September to November, which might have been associated with seasonal change or availability of student health insurance at the start of the academic year. Conclusion: Our findings show a high level of inappropriate antibiotics usage at a dental teaching hospital in Indonesia, and indicate that there is a need for educational initiatives and guidelines to promote best practice and appropriate use of antibiotics in this hospital.
Keywords
Antibiotics Utilization, Dental Teaching Hospital, Yogyakarta, Indonesia
To cite this article
Mayu Winnie Rachmawati, Naoko YOSHIDA, Hirohito TSUBOI, Kazuko KIMURA, Antibiotic Utilization in a Dental Teaching Hospital in Yogyakarta, Indonesia, Science Journal of Clinical Medicine. Vol. 3, No. 3, 2014, pp. 37-42. doi: 10.11648/j.sjcm.20140303.12
References
[1]
Nepalese National Formulary (NNN) 1st ed. Nepal: Kathmandu Nepal Ministry of Health; 1997
[2]
Dar-Odeh, Soukaina Ryalat, Mohammad, Mohammad Shayyab, Osama Abu-Hammad, Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections, Ther and Clin Risk Manag 2008 ; 4(5) : 1111-7
[3]
Lewis MA, Why we must reduce dental prescription of antibiotics: European Union Antibiotic Awareness Day, Br Dent J., 2008 Nov 22; 205 (10): 5378 http://doi:10.1038/sj.bdj.2008.984
[4]
World Health Organization (WHO), The Role of Education in the Rational Use of Medicines, SEARO Technical Publication Series No.45, 2006, New Delhi, India
[5]
Nandimath Mk and Ahuja S., Drug Prescribing Pattern in Upper Respiratory Tract Infection in Children Aged 1-14 Years, International Journal of Pharma and Bio Sciences, 2012; 3 (1): 299-308
[6]
Truter I, A review of Drug Utilization Studies and Methodologies, Jordan J Pharm Sci, 2008; 1 (2): 91-104
[7]
Naik HG, Khanwelkar CC, Kolur A, Desai R, and Gidamudi S, Drug utilization study on antibiotics use in lower respiratory tract infection, Natl J Med Res, 2013; 3 (4): 324-7
[8]
Swift JQ and Gulden WS, Antibiotic therapy-managing odontogenic infections, Dent Clin North Am, 2002; 46(4): 623-33, vii
[9]
Thomas DW, Satterwaite J, Absi EG, Lewis MA, and Shepherd JP, Antibiotic prescription for acute dental conditions in primary care setting, Br Dental J, 1996; 181 (11-12): 401-4
[10]
World Health Organization Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC Classification and DDD Assignment, 5th edition, Oslo, Norway, World Health Organization, 2002.
[11]
Lewis MAO, MacFarlane TW, and McGowan DA, A microbiological and clinical review of acute dentoalveolar abscess, J Oral Med and Pathol, 1990; 28: 359-66
[12]
Lewis MAO, Pankhust CL, Douglas CWI, Martin MV, Absi EG, Bishop PA, and Jones SA, Prevalence of penicillin resistant bacteria in acute suppurative oral in-fection, J Antimicr Chemother, 1995; 35: 785-91
[13]
Palmer NOA, Martin MV, Pealing R, and Ireland RS, An analysis of antibiotic prescriptions from general dental practitioners in England, J Antimicr Chemother, 2000; (46): 1033-5
[14]
Jaunay T, Sambrook P, and Goss A, Antibiotic prescribing practices by South Australilan general dental practitioners, Austr Dent J, 2000; 45 (3): 179-86
[15]
Tenenbaum H. Jehl F, Gallion C, and Dahan M, Amoxicillin and clavulanic acid concentrations in gingival crevicular fluid. J Clin Periodontol 1997, 24: 804-7
[16]
van der Bijl P, Clindamycin in dentistry, J Dent Assoc S Afr, 1994; 49 (11): 563-6
[17]
Pipalova R, Vleck J, and Slezak R, The trends in antibiotic use by general dental practitioners in the Czech Republic (2006-2012), Int Dent J, 2014 http://doi:10.1111/idj.12089
[18]
Brook I, Lewis MA, Sandor GK, Jeffcoat M, Samaranayake LP, and Vera Rojas J, Clindamycin in dentistry: more than just effective prophylaxis for endocarditis?, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 100 (5): 550-8
[19]
Addy M and Martin M, Systemic antimicrobials in the treatment of chronic peri-odontal diseases: a dilemma, Oral Diseases, 2003; 9 (Suppl.1): 38-44
[20]
Roy KM and Bagg J, Antibiotic prescribing by general dental practitioners in the Greater Glasgow Health Board, Scot-land, British Dent J, 2000; 188 (12): 674-6
[21]
Dar-Odeh NS, Abu-Hammad OA, Al-Omiri MK, Khraisat AS, and Shehabi AA, Antibiotic prescribing practices by dentists: a review, Ther and Clin Risk Manag, 2010; 6: 301-6
[22]
Salako NO, Rotimi VO, Adib SM, and Al-Mutawa S, Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait, J Dentistry, 2004; 32: 503-9
[23]
Al-Haroni M and Skaug N, Knowledge of prescribing antimicrobials among Yemeni general dentists, Acta Odont Scand, 2006; 64: 570-4
[24]
Reebye UN, Ollerhead TR, Hughes CV, and Cottrell DA, The microbial composition of mandibular third molar pericoronal infections, J Mass Dent Soc, 2002; 51 (2): 48-51
[25]
Informal conversation, 2013
[26]
Al-Mubarak S, Al-Nowaiser, Rass MA, Alsuwyed A, Alghofili A, Al-Mubarak EK, Anti-biotic prescription and dental practice within Saudi Arabia; the need to reinforce guidelines and implement specialty needs, J Int Acad Periodontol, 2004; 6: 47-55
[27]
Farzeen T and Khan S, Antibiotic prescription habits of dentists in major cities of Pakistan, J Pak Dent Asso, 2011; 20: 159-4
[28]
Murti A and Morse Z, Dental antibiotic prescription in Fijian Adults, Int Dent J, 2007; 57 (2): 65-70
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