Prescrição de antibióticos durante o tratamento de canais radiculares: questionário envolvendo endodontistas brasileiros

Abstract

The objective of this study was to investigate the antibiotics prescribing habits reported by Brazilian endodontists in specific clinical situations. An on-line questionnaire was sent to Brazilian endodontists via e-mail and social media network. A total of 633 questionnaires were answered. Data were analyzed descriptively. The majority of the respondents reported to prescribe antibiotics for 7 days (67.3%). The first antibiotic of choice was 500mg amoxicillin, chosen by 79% of the respondents. 500 + 125mg Amoxicillin + clavulanate potassium was selected by 31% as a second option. For patients allergic to penicillin, 30.53% prescribe clindamycin, and 27.78% prescribe azithromycin (250mg and 500mg). Half of the professionals do not use loading dose and 36% use with twice the regular concentration, one hour before treatment. For acute apical abscesses (AAA) with intra and extraoral diffuse swelling, fever and trismus, 90.36% reported to prescribe antibiotics. 87.99% prescribe antibiotics for cases without extraoral AAA swelling. 60.66% prescribe antibiotics for cases of AAA with intraoral swelling and pain. In cases of pulp necrosis, chronic apical periodontitis, and sinus tract, antibiotics were prescribed by 20.54%. In pulp necrosis, swelling and pain with AAA, 53.08% prescribed antibiotics. In case of root-end surgery, 45.02% of respondents prescribe antibiotics. Although part of the endodontists reported a conscious conduct in the use of antibiotics, overpresctiption could be observed in situations where the prescription of antibiotic would not be necessary and the duration of prescriptions was beyond necessary. Thus, there is a need of professional awareness, as excessive and incorrect prescription of antibiotics in endodontics might contribute to the global problem of increasing microbial resistance.