[Evaluation of antibiotherapy in dental surgery]

Debate on antibiotic prophylaxis in patients with infectious endocarditis has emphasized the need for reliable data on the effectiveness of antibiotic therapy in dentistry patients.

We randomly sampled 583 antibiotic prescriptions delivered by dentists working in out-patient clinics in the French department of Gironde in 1992. Two-hundred fifty-seven prescriptions were analyzed in detail after telephone contact with the prescribing practicians in coordination with infectiology experts from university hospitals.

Antibiotic treatment was successful in 85.6% of the cases. The indication was justified in 74.1% and the dose was judged insufficient in 24% as was the administration rhythm in 37.8%. The duration of treatment was not in conformity with generally accepted prescription in 23.1% of the cases, usually being too short. According to the recommendations of the Consensus Conference on prophylaxis against infectious endocarditis held in Paris, March 27, 1992, antibiotic prophylaxy was not justified in 14.4% of the cases. In addition, the drug chosen in these cases was not in conformity with the recommendations in 43.2% and the duration in 100%.

These findings emphasize that more adapted university and postgraduate training in antibiotic prescription both for prophylaxis and cure is needed in odontostomatology since a large number of antibiotics prescriptions are delivered by dentists.