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Trends of usage of antimicrobial agents in dental practice on the basis of prescription analysis. Oral cavity organisms . more than 400 species Aerobic as well as anaerobic Anerobic 10 – 100 times more Spirochetes, Candida, viral. To deal with -. Dental Caries

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Trends of usage of antimicrobial agents in dental practice on the basis of prescription analysis

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Trends of usage of antimicrobial agents in dental practice on the basis of prescription analysis l.jpg

Trends of usage of antimicrobial agents in dental practice on the basis of prescription analysis

Oral cavity organisms l.jpg

Oral cavity organisms

  • more than 400 species

  • Aerobic as well as anaerobic

  • Anerobic 10 – 100 times more

  • Spirochetes, Candida, viral

To deal with l.jpg

To deal with -

  • Dental Caries

  • Dentoalveolar abscess, pulp infection, periapical abscess

  • Gingivitis

  • Periodontitis – pericoronitis, periodontal abscess, osteomyelitis, peri-implantitis

  • Deep fascial infection

Indications for chemotherapeutic agents l.jpg

Indications for Chemotherapeutic Agents

  • Orodental Infections

  • To prevent other infections – bacterial endocarditis

  • To prevent postoperative infection

  • Improve healing

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Aims of study

  • To get general idea of prescribing trends

  • Comparing the trends in institutional practice and private practice

  • To analyze the prescriptions in order to determine -

    • The rationale - indications, adequacy of dosage, and duration of treatment

    • The adequacy for prophylaxis

    • The attention given to - contraindications and precautions

Period of study 01 01 05 06 30 05 6 months l.jpg

Period of study: 01/01/05–06/30/05: 6 months

Material: OPD antimicrobial Prescriptions

  • Data collected from –




    ¤ GDP: 20 (General Dental Practitioners)

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Private clinics l.jpg


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TRENDS – Institutes Vs Private

Trends l.jpg


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Other remarkable observations


  • Ciprofloxacin ( up to 5 years): 1.3%

  • Ciprofloxacin ( 5-10 years): 2.7%

  • Ciprofloxacin ( > 10 years): 3%

  • Inadequate frequency of admn

  • Amoxicillin: 250 mg bid: 16.7%

  • Ampicillin: 250 mg bid: 15%

Timing of treatment prophylaxis l.jpg

Timing of treatment/prophylaxis

  • Inadequate duration: 19.4%

    Ciprofloxacin single dose, Amoxicillin 2 days, Ampicillin 2 days

  • Antibiotic started after the procedure: 61.3%

Oro dental infections l.jpg


  • Periapical/Periodontal Abscess

  • Acute Suppurative pulpitis/Toxic cellulitis.

  • Salivary Gland Sepsis/Sinusitis

  • Post Surgical/Post Traumatic.

  • Oro-antral/Oro-nasal Fistula.

  • Ludwig’s angina/Purulent osteitis

  • Pericoronitis/Mucositis/Pemphigus

Spectrum l.jpg


Prophylaxis prevention l.jpg

Prophylaxis (Prevention)

  • Bacterial Endocarditis.

  • Prosthetic Joint Infections.

  • Immuno-Compromised Hosts.

  • Procedures and others.

Sbe prophylaxis l.jpg



  • Extractions, Periodontal procedures

  • Prophylactic cleaning

  • Implant placement, Re-implantation

  • Endodontic Instrumentation/Surgery beyond root apex, Placement or removal of orthodontic bands

  • Intraligamentary LA

Sbe prophylaxis 1 l.jpg


(1 hr before procedure)


    Amoxicillin 2 g


    Clindamycin 600 mg

    Cephalexin/Cefadroxil 2 gm

    Clarithromycin/Azithromycin 500 mg

Sbe prophylaxis 2 l.jpg


30 mins before procedure)

  • Failure to take P/O

    Ampicillin 2 gm IM/IV

  • Penicillin allergy & Failure to take P/O

    Clindamycin 600 mg IV

    Cefazolin 1 gm IM/IV

Prefer l.jpg





Inferences l.jpg


  • Most commonly prescribed antimicrobials were quinolones in combination with metronidazole and tinidazole (51% ).

  • Amongst the quinolones, ciprofloxacin and ofloxacin were the quinolones chosen by 95% of the prescribers.

  • Quinolones – ciprofloxacin, ofloxacin were prescribed alone by 10% prescribers.

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  • 4. Inadequacy of the frequency of administration was found in 15-17% prescriptions.

  • 5. Inadequate duration of treatment was observed in 19.4% prescriptions.

  • 6. First generation quinolones were prescribed to the children in the range of 1-3% of the prescriptions given for quinolones.

  • 7. The antimicrobial agent was started AFTER THE PROCEDURE in about 61% cases.

Bibliography l.jpg


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