Private Practice Dentists Improve Antibiotic Use After Dental Antibiotic Stewardship Education From Infectious Diseases Experts.
Private Practice Dentists Improve Antibiotic Use After Dental Antibiotic Stewardship Education From Infectious Diseases Experts.
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DOI：
10.1093/ofid/ofac361
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发表时间：
2022-08
影响因子：
4.2
通讯作者：
中科院分区：
文献类型：
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作者：
私人执业牙医占美国牙医的72%。我们对私人执业牙医进行了一项前瞻性队列研究，比较传染病（ID）抗生素管理专家进行牙科抗生素管理教育前后的抗生素使用情况。研究阶段如下：阶段1（教育前），3个月的回顾性抗生素数据和调查前评估的基线抗生素知识;阶段2（教育），牙医参加了3个晚上的Zoom会议;阶段3，（教育后/干预），3个月的前瞻性审计，每周反馈;阶段4，调查后和建议，以达到更多的牙医。15名牙医参加。十个人练习了20年以上。调查前，14人不熟悉牙科管理。术前/术后抗生素处方数量从2124例下降到1816例（P < .00001），而手术数量从8526例增加到9063例。总体而言，适当使用（预防和治疗）从治疗前的19%增加到治疗后的87.9%（P < .0001）。适当的预防治疗前为46.6%，治疗后为76.7%（P <0.0001）。关节植入预防性治疗从术前的164例减少到术后的78例（P < .0001）。适当的治疗前/后抗生素从15%提高到90.2%（P = .0001）。抗生素治疗前/后的持续时间从7.7天（标准差[SD]，2.2天）减少到5.1天（SD，1.6天）（P < .0001）。克林霉素的使用从治疗前的183例减少到治疗后的18例，减少了90%（P <0.0001）。调查后的回复建议将抗生素管理作为一项必要的年度继续教育。研究参与者邀请ID抗生素管理专家通过牙科学习俱乐部教授另外2125名牙医。在从ID抗生素管理专家那里学习了牙科抗生素管理之后，牙医迅速优化了抗生素处方。私人执业牙科研究俱乐部正在将牙科抗生素管理培训扩大到美国各地的其他牙医，牙医和患者。在抗生素管理教育与传染病专家的审计和每周反馈干预后，牙医显着改善了抗生素的适当使用率从19%提高到87.9%。他们的全国牙科研究俱乐部网络继续让更多的牙医参与牙科抗生素管理。
Private practice dentists represent 72% of United States dentists. We conducted a prospective cohort study of private practice dentists comparing antibiotic use before and after dental antibiotic stewardship education by infectious diseases (ID) antibiotic stewardship experts. Study phases were as follows: phase 1 (preeducation), 3 months of retrospective antibiotic data and a presurvey assessed baseline antibiotic knowledge; phase 2 (education), dentists attended 3 evening Zoom sessions; phase 3, (posteducation/interventions), 3 months of prospective audits with weekly feedback; phase 4, postsurvey and recommendations to reach more dentists. Fifteen dentists participated. Ten had practiced >20 years. Presurvey, 14 were unfamiliar with dental stewardship. The number of antibiotic prescriptions pre/post decreased from 2124 to 1816 (P < .00001), whereas procedures increased from 8526 to 9063. Overall, appropriate use (prophylaxis and treatment) increased from 19% pre to 87.9% post (P < .0001). Appropriate prophylaxis was 46.6% pre and 76.7% post (P < .0001). Joint implant prophylaxis decreased from 164 pre to 78 post (P < .0001). Appropriate treatment antibiotics pre/post improved 5-fold from 15% to 90.2% (P = .0001). Antibiotic duration pre/post decreased from 7.7 days (standard deviation [SD], 2.2 days) to 5.1 days (SD, 1.6 days) (P < .0001). Clindamycin use decreased 90% from 183 pre to 18 post (P < .0001). Postsurvey responses recommended making antibiotic stewardship a required annual continuing education. Study participants invited ID antibiotic stewardship experts to teach an additional 2125 dentists via dental study clubs. After learning dental antibiotic stewardship from ID antibiotic stewardship experts, dentists rapidly optimized antibiotic prescribing. Private practice dental study clubs are expanding dental antibiotic stewardship training to additional dentists, hygienists, and patients across the United States. Dentists significantly improved appropriate antibiotic use from 19% to 87.9% after antibiotic stewardship education with audit and weekly feedback interventions by infectious diseases experts. Their national network of dental study clubs continues to engage additional dentists in dental antibiotic stewardship.
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影响因子：
4.5
作者：
Carlsen DB;Durkin MJ;Gibson G;Jurasic MM;Patel U;Poggensee L;Fitzpatrick MA;Echevarria K;McGregor J;Evans CT;Suda KJ
通讯作者：
Suda KJ
影响因子：
3.9
作者：
Durkin, Michael J.;Hsueh, Kevin;Fraser, Victoria J.
通讯作者：
Fraser, Victoria J.
影响因子：
4.5
作者：
Gross, Alan E.;Suda, Katie J.;McGregor, Jessina C.
通讯作者：
McGregor, Jessina C.
影响因子：
11.8
作者：
Fernandez-Lazaro, Cesar, I;Brown, Kevin A.;Schwartz, Kevin L.
通讯作者：
Schwartz, Kevin L.
抗生素预防在牙种植手术中的效果：一项多中心安慰剂对照双盲随机临床试验。
影响因子：
3.6
作者：
通讯作者：
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