Patient automedication and professional prescription pattern in an urgency service in Brazil

Several studies have indicated an increased resistance of microorganisms resulting from the widespread use of antimicrobial agents. However, few data are available in the dental literature. The aim of this study was to conduct a survey on the patterns of patient usage of antimicrobial prescriptions agents by dentists. A retrospective cross-sectional study was based on the medical records of 223 patients who sought treatment at the Urgency Service, from a Dental School in the South of Brazil, from March 2009 to March 2011. A specific data sheet was used, with questions regarding: patient age and gender; the main complaint; medications used prior to the service; final diagnosis; proposed dental treatment (including prescription medications); and characteristics of the final prescription. Descriptive and inferential statistics were obtained. There was a high frequency of antibiotic use prior to attendance by young patients (Fisher's exact test, p < 0.05). Toothache of endodontic origin was the most frequent patient complaint (72.6%). Endodontic procedures were the measures most frequently adopted to treat the pain (31.2%). The frequency of patient use of antimicrobials prior to the appointment was 14.3%. According to patient records, 83.9% had no systemic drug prescription after receiving urgency treatment. There were few antimicrobial prescriptions after the urgency treatment. The most frequently prescribed agents were amoxicillin, chlorhexidine, and metronidazole. Local measures were more frequently used than systemic approaches to treat urgencies of dental origin. Antimicrobial agents were not frequently prescribed as adjunctives to local administered at the urgency service.