The pattern of antibiotic prescribing by dental practitioners in Zagreb, Republic of Croatia

Aim To examine the pattern of antibiotic prescribing by Croatian dentists in the Zagreb area. Methodology The first part of a questionnaire comprised data about the doctor of dental medicine (DMD) and the second part was a table which was filled out by the examined doctors over the period of two months. The table comprised the data on patients and antibiotics prescribed during that period (patient's age, their gender, the name of antibiotics, dosage, frequency, duration of therapy, state or diagnosis and the reason for prescribing antibiotics). 220 DDMs were contacted personally, out of which 110 filled out and returned the questionnaire. Statistical significance was tested by Fisher’s exact test, chi-square test and Mann-Whitney U test at the level p<0.05. Results In the first part of the study Fisher's exact test showed the difference between specialists and GDPs in the percentage of doctors who claim that the most commonly used amoxicillin and clavulanic acid in a fixed combination (p=0.012). Doctors' age was significantly associated with the statement of metronidazol as one of the most common prescribed antibiotics (χ2=15.08, df=2, p=0.001). The difference in median age between male and female patients was not statistically significant (Mann-Whitney, U=249428, Z=-1.51, p=0.130). During the examined period the doctors prescribed antibiotics for a total 1500 patients (4.2% of all treated patients) out of which 690 (46%) were men and 810 (54%) were women. The most often prescribed antibiotics were beta-lactam penicillins (in 72.5% of patients), represented by amoxicillin in combination with clavulanic acid (the most frequently prescribed generic antibiotic - 57.6%). The most common diagnosis for which the antibiotics were prescribed was endodontic or periodontal abscess (44%). Definite clinical indication (71.2%) was stated as the most common reason for antibiotic prescription. Therapy usually lasted 7 days (62.9%). The subjects mainly prescribed daily doses of antibiotics according to the instructions for the use of specific drugs. Conclusions The examined subjects prescribe antibiotics according to the recommendations for each type, dose and duration of the treatment, although an inconsistency in diagnoses and reasons for antibiotic prescription was observed.