A survey on systemic antibiotic prescription among dentists in Romandy

Antimicrobial resistance (AMR) is a significant global health threat that arises from the excessive and incorrect use of antibiotics. As key players in the evolution of AMR, medical and dental practitioners are often questioned on their indications for antibiotic prescription during daily practice. The present survey aimed to evaluate self-reported practices regarding systemic antibiotic prescription among Swiss dentists in Romandy. An electronic questionnaire was sent to 331 dentists working in the French-speaking part of Switzerland and the responses were analyzed on a three-point Likert scale. The response rate was 28%. Results showed that the main indications for antibiotic use were abscesses with systemic symptoms (89%), cellulitis (81.5%), acute sinusitis (62%) and necrotizing periodontitis (52%). Surgical procedures most frequently combined with antibiotics were sinus floor elevation (59.8%) and implant placement (60.9%). Amoxicillin was the first-choice antibiotic, and clindamycin was mostly prescribed for patients with a penicillin allergy (87%). The majority of dentists recommended prophylaxis with 2g of amoxicillin, one hour before the procedure for patients with a high risk of endocarditis (82.6%), immunodeficiency / immunosuppression (50%), or joint replacement during the last year (47.8%). Most participants (76.1%) expressed the need for specific guidelines on the use of antibiotics in dentistry. The research findings suggested antibiotic prescriptions in dentistry could profit from stricter guidelines.