Patterns of Antibiotic Prescription in Implant Surgery in Sweden

Dr. Bodil Lund, Dr. Margareta Hultin, Dr. Dalia Khalil

Drs. Bodil Lund and Dalia Khalil spoke with Dr. Suham Alexander about their latest research into the patterns of antibiotioc prescription in Sweden.

Highlights

Antibiotic prophylaxis is often required to prevent bacterial infection pre- or post-procedure. Controversy exists regarding the benefits of prescribing antibiotics for routine implant placement surgery. The risks associated with improper or overuse of antibiotics is well-documented – emergence of resistant strains, side-effects, drug interactions and allergies. This investigation studied the prescription patterns of Swedish dentists before and after the publication of recommendations on dental implant procedures and antibiotic use (2008 and 2012, respectively).

The study results revealed that:

• Dentists that did not have postgraduate clinical training were most likely to prescribe prophylactic antibiotics beyond the day of surgery.
• Between 2008 and 2012, there was a significant decrease in the number of dentists who prescribed antibiotics for a defined local rationale during implant surgery.
• Between 2008 and 2012, there was also a significant decrease in the number of dentists who routinely prescribed antibiotics beyond the day of surgery.
• Dentists who had read the recommendations were more likely to prescribe a single dose of antibiotics for the implant surgery
• In the same time period, penicillin prescriptions decreased while amoxicillin prescriptions increased. Clindamycin and metronidazole were not commonly prescribed.

The authors concluded from the study that the publication of recommended guidelines for antibiotic use for implant surgery influenced the prescription patterns of the investigation. Furthermore, the study revealed that dentists with postgraduate training were more cautious in prescribing antibiotics to their patients.

Associate Professor Bodil Lund is Chairman of the Section of Oral and Maxillofacial Surgery, Karolinska Institutet and Consultant surgeon at the Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.

Her main research focus is antibiotic resistance, nosocomial infections and temporomandibular joint surgical disease. She is Commissioner in the National Dentistry Section of STRAMA (Swedish Strategic Program against Antibiotic Resistance). Together with Associate professor Margareta Hultin, Karolinska Institutet, she runs a research group with focus on antibiotic utilization and efficacy in dentistry.

Dr. Dalia Khalil, DDS, PhD student, Department of Dental Medicine, Division of Periodontology Karolinska Institutet, Huddinge, Sweden

Her research area focus ia the use of antibiotics in dentistry, specifically dental implant, from the clinical and microbiological prospective and its effect on the development of antibiotic resistance. In addition to investigating different protocols for the treatment of peri-implantitis.