Amaç: Bu çalışmanın amacı, pediatrik hastaların dental problemlerinde antibiyotik kullanımının değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışma, 166 kız (8,64±2,5 yaş) ve 184 erkek (8,35±2,5 yaş) birey ile yürütülmüştür. Araştırma, sosyodemografik veriler ve klinik bulgulara ait verileri içeren bir anket formu hazırlanarak ebeveynlere yüz yüze görüşme yöntemiyle uygulanmıştır. Elde edilen verilerin istatistiksel analizi ki-kare testi, Student t-testi ve lojistik regresyon analizi kullanılarak gerçekleştirilmiştir (α=0,05). Bulgular: Çalışmanın sonuçlarına bakıldığında, dişlerin pulpal/periapikal değerlendirmesine göre antibiyotik kullanımı endike olan hastalardan, antibiyotik kullananların oranı %77,7 iken endike olmadığı hâlde antibiyotik kullananların oranı %50,6 olarak belirlenmiştir (p<0,001). Bu vakalardan kanal tedavisi uygulananların %68,2'sine ve çekim uygulananların %80'ine antibiyotik reçete edildiği; vital pulpa tedavisi uygulananların %31,7'sine ise gerekli olmadığı hâlde antibiyotik reçete edildiği belirlenmiştir (p<0,001). Herhangi bir sistemik hastalık nedeni ile düzenli ilaç kullanımı olan çocukların, dental nedenlerle antibiyotik kullanım oranlarının sağlıklı bireylere kıyasla istatistiksel olarak anlamlı derecede düşük olduğu tespit edilmiştir (p=0,008). Antibiyotik kullanan hastaların yaş ortalamaları kıyaslandığında, küçük yaş grubundaki hastalarda (8,19±2,5 yaş) istatistiksel olarak anlamlı derecede daha fazla antibiyotik kullanımı olduğu görülmüştür (p=0,002). Ayrıca çalışmaya katılan ebeveynlerin sadece %23,4'ünün, antibiyotik direnci kavramından haberdar olduğu tespit edilmiştir. Sonuç: Çocuk hastalarda, antibiyotiklerin gereksiz veya yanlış kullanılmasının önlenmesi amacıyla diş hekimleri ile toplumun bilgilendirilmesi gerekmektedir. Buna bağlı olarak antibiyotiklerin doğru kullanılmasıyla ilgili farkındalık oluşturmak için yapılan çalışmaların artırılması gerektiği düşünülmektedir.
Anahtar Kelimeler: Antibiyotikler; antibiyotik direnci; çocuklar; ebeveyn; dental problem
Objective: The aim of this study was to evaluate the use of antibiotics in dental problems in pediatric patients. Material and Methods: This study was conducted with 166 girls (8.64±2.5 age) and 184 boys (8.35±2.5 age). A questionnaire including the data on sociodemographic status and clinical findings was prepared and presented to the parents by face-to-face interview method. Statistical analysis of the obtained data was performed by using chi-square and Student t-tests and logistic regression analysis (α=0.05). Results: Based on the results of this study, according to the pulpal/periapical evaluation of the teeth, the rate of antibiotic usage in patients with dental indication was 77.7%, whereas the rate of antibiotic usage in patients without dental indication was 50.6% (p<0.001). It was determined that among these cases, antibiotics were prescribed for 68.2% of the patients who got root canal therapy, 80% of patients who had indication of extraction, and although it was not required, 31.7% with vital pulp (p<0.001). The rate of antibiotic usage of children with regular drug usage due to systemic disease was statistically significantly lower than healthy ones (p=0.008). According to the comparison of the mean age of the patients who used antibiotics, excess antibiotic usage was observed in younger age group (8.19±2.5 age) (p=0.002). Furthermore, only 23.4% of respondent parents were aware of antibiotic resistance. Conclusion: Dentists and the community should be informed to prevent unnecessary or misuse of antibiotics in pediatric patients. Consequently, further research should be carried on continuously to raise awareness about the rational use of antibiotics.
Keywords: Antibiotics; antibiotic resistance; children; parents; dental disease
- Karabay O. [Antibiotic consuption in Turkey and where the antibiotic resistance goes?]. ANKEM Derg. 2009;23(Ek 2):116-20.
- Tartar AS, Denk A, Özden M, Çelik Kırık Y, Akbulut A, Demirdağ K. [Investigation of the rationality of antibiotic use in the fırat university hospital: a point prevalence study]. ANKEM Derg. 2015;29(1):16-20.
- WHO. The Rational Use Of Drugs: Report Of The Conference Of Experts, Nairobi, 25-29 November 1985. Geneva, Switzerland: World Health Organization; 1987. p.329.
- Nathwani D, Davey P. Antibiotic prescribing--are there lessons for physicians? QJM. 1999;92(5):287-92. [Crossref] [PubMed]
- Tünger O, Dinç G, Ozbakkaloglu B, Atman UC, Algün U. Evaluation of rational antibiotic use. Int J Antimicrob Agents. 2000;15(2):131-5. [Crossref] [PubMed]
- WHO. Antimicrobial resistance. Updated February 2018. Last accessed on 2019, May 11. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
- Pallasch TJ. Global antibiotic resistance and its impact on the dental community. J Calif Dent Assoc. 2000;28(3):215-33. [PubMed]
- Al-Johani K, Reddy SG, Al Mushayt AS, El-Housseiny A. Pattern of prescription of antibiotics among dental practitioners in Jeddah, KSA: a cross-sectional survey. Niger J Clin Pract. 2017;20(7):804-10. [PubMed]
- American Academy of Pediatric Dentistry. Use of antibiotic therapy for pediatric dental patients. Pediatr Dent. 2014;40(6 18/19):383-5. http://www.mychildrensteeth.org/media/Policies_Guidelines/BP_AntibioticTherapy.pdf
- Sivaraman SS, Hassan M, Pearson JM. A national survey of pediatric dentists on antibiotic use in children. Pediatr Dent. 2013;35(7):546-9. [PubMed]
- Davis ME, Liu TL, Taylor YJ, Davidson L, Schmid M, Yates T, et al. Exploring patient awareness and perceptions of the appropriate use of antibiotics: a mixed-methods study. Antibiotics (Basel). 2017;6(4):23. [Crossref] [PubMed] [PMC]
- Zahreddine L, Hallit S, Shakaroun S, Al-Hajje A, Awada S, Lahoud N. Knowledge of pharmacists and parents towards antibiotic use in pediatrics: a cross-sectional study in Lebanon. Pharm Pract (Granada). 2018;16(3):1194. [Crossref] [PubMed] [PMC]
- Longman LP, Preston AJ, Martin MV, Wilson NH. Endodontics in the adult patient: the role of antibiotics. J Dent. 2000;28(8):539-48. [Crossref] [PubMed]
- Salako NO, Rotimi VO, Adib SM, Al-Mutawa S. Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait. J Dent. 2004;32(7):503-9. [Crossref] [PubMed]
- Fuks AB. Vital pulp therapy with new materials for primary teeth: new directions and treatment perspectives. J Endod. 2008;34(7 Suppl):18-24. [Crossref] [PubMed]
- Camp JH, Fuks AB. Pediatric endodontics: endodontic treatment for the primary and young permanent dentition. In: Hargreaves KM, Cohen S, Berman LH, ed. Cohen's Pathways of the Pulp. 10th ed. St Louis, Mo: Mosby Elsevier; 2011. p.808-57. [Crossref]
- Murray JJ, Majid ZA. The prevalence and progression of approximal caries in the deciduous dentition in British children. Br Dent J. 1978;145(6):161-4. [Crossref] [PubMed]
- McDonald RE, Avery DR, Stookey G. Dental caries in the child and adolescent. Dentistry for the Child and adolescent. 6th ed. Maple, Vail-York; 1994. p.87-9.
- Goud SR, Nagesh L, Fernandes S. Are we eliminating cures with antibiotic abuse? A study among dentists. Niger J Clin Pract. 2012;15(2):151-5. [Crossref] [PubMed]
- Gonul O, Aktop S, Satilmis T, Garip H, Goker K. Odontogenic infections. In: Motamedi MH, ed. A Textbook of Advanced Oral and Maxillofacial Surgery. 1st ed. Turkey: InTech; 2013. p.47-65. [Crossref]
- Karibasappa G, Sujatha A. Antibiotic resistance-a concern for dentists. IOSR J Dent Med Sci. 2014;13(2):112-8. [Crossref]
- Rothman RL, Yin HS, Mulvaney S, Co JPT, Homer C, Lannon C. Health literacy and quality: focus on chronic illness care and patient safety. Pediatrics. 2009;124(Suppl 3):S315-26. [Crossref] [PubMed]
- Keim-Malpass J, Letzkus LC, Kennedy C. Parent/caregiver health literacy among children with special health care needs: a systematic review of the literature. BMC Pediatr. 2015;15:92. [Crossref] [PubMed] [PMC]
- Castro-Sánchez E, Chang PWS, Vila-Candel R, Escobedo AA, Holmes AH. Health literacy and infectious diseases: why does it matter? Int J Infect Dis. 2016;43:103-10. [Crossref] [PubMed]
- Aleem MA, Rahman MM, Ishfaq M, Mehmood K, Ahmed SS. Determinants of antibiotics misuse by the parents in children: a survey from northern region of Saudi Arabia. Bangladesh J Child Health. 2017;40(2):64-71. [Crossref]
.: İşlem Listesi