Antibiotic Use by Members of the Spanish Endodontic Society

Introduction: The purpose of this study was to determine the prescribing habits of active members of the Spanish Endodontic Society (AEDE) with regard to antibiotics. Methods: A one-page questionnaire was sent to the active members of the AEDE. Of the 508 surveys mailed, 158 surveys were returned, and 140 were found to be usable. The overall response rate was 31.1%. The data were analyzed by using descriptive statistics and chi-square tests of independence. Results: The average duration of antibiotic therapy was 6.8 +/- 1.8 days. In patients with no medical allergies, most of the responders (86.1%) selected amoxicillin as the first-choice antibiotic, alone (44.3%) or associated with clavulanate (41.8%); metronidazole-spiramycin and clindamycin were prescribed by 7.6% and 3.7% of the respondents. The first drug of choice for patients with an allergy to penicillins was clindamycin 300 mg (63.2%) followed by metronidazole-spiramycin (23.7%). For cases of irreversible pulpitis, 40.0% of respondents prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis, and no swelling, 52.9% prescribed antibiotics. Almost 21.5% prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract. Conclusions: For the most part, the majority of the members of the AEDE were selecting the appropriate antibiotic for use in orofacial infections, but there are still many who are prescribing antibiotics inappropriately. The use of antibiotics for minor infections, or in some cases in patients without infections, could be a major contributor to the world problem of antimicrobial resistance. (J Endod 2009;35:1198-1203)