Evaluation of prescribing trends of antibiotics during the treatment of periodontal diseases in Turkey

The mechanism of periodontal diseases are multifactorial and very complex. Pathogens in microbial dental plaque and their products initiate the inflammation process and causes it to advance. Successful treatment is very difficult to achieve as there are hundreds of species that are associated with the disease. According to American Academy of Periodontology (AAP) antimicrobials may be prescribed adjacent to mechanical therapy in refractory and aggressive periodontitis cases, in patients with fever and lymphadenopathy adjacent to acute periodontal infections (periodontal abscess, acute necrotizing ulcerative gingivitis, pericoronitis), and in patients that have systemic diseases which makes them prone to periodontitis. It is not necessary to prescribe antibiotics in gingivitis and slight to moderate chronic periodontitis cases. Benefits of adjunct use of antimicrobials have been proven, but they have to be used cautiously because of side effects and development of resistance to antibiotics. Rational use of medicines means determining the best medicine for patients after correct diagnosis and appropriate use of medicine. İrrational prescription of medicine is a global problem. The mostly encountered examples are irrational selection of antibiotics, use of excessive amount of medicine, selecting expensive medicine when there are cheaper alternatives. According to several studies antibiotics are prescribed even when they are not indicated and there is a flaw in duration of use and dose. The main problem associated with irrational use of antibiotics is development of microbial resistance. Sadly, there are limited number of studies analyzing rational use of medicine in our country. In our study, survey that is composed of questions about use of antibiotics in several periodontal pathological conditions and periodontal procedures was sent to members of İstanbul Diş Hekimleri Odası through mail and to groups of dentists through social media and requested them to answer it on Survey Monkey platform. 289 dentists completed the questionnaire. Prescription trends of dentists in several periodontal pathological conditions and periodontal procedures was analyzed. According to the results of the study, trends toward prescribing antibiotics when they are not indicated and not prescribing antibiotics when they are indicated, trend toward irrational prescribing of antibiotics during nonsurgical and surgical periodontal procedures was found and trend toward prescribing antibiotics was higher among dentists that have been in practice for more than 15 years, dentists without specialty training and dentists in private dental practice.