An evaluation of antibiotic prescribing practices among dentists in Lahore: A cross-sectional study

Antibiotic Prescribing Practices Among Dentists in Lahore


  • Palwasha Babar Department of Operative and Pediatric Dentistry, University College of Dentistry, The University of Lahore
  • Maryam Virda Department of Operative and Pediatric Dentistry, University College of Dentistry, The University of Lahore
  • Adeel Haider Department of Oral Pathology, University College of Dentistry, The University of Lahore
  • Wajiha Alamgir Department of Oral Pathology, University College of Dentistry, The University of Lahore
  • Muhammad Afzal Department of Prosthodontics, Institute of Dentistry, CMH Lahore Medical College, National University of Medical Sciences (NUMS)
  • Rana Muhammad Ahmad Khan Department of Operative and Pediatric Dentistry, University College of Dentistry, The University of Lahore



Antibiotics, Drug misuse, Drug Overuse, Evidence-Based Dentistry


The appropriate use of antibiotics has become a major concern in healthcare. The over prescription and misuse of antibiotics has contributed to antibiotic resistance which has emerged as a major public health issue. Objective: The current study is conducted to investigate the antibiotic use by the dentists and to assess the conformity with evidence-based guidelines. Methods: A convenience sample of 216 dental practitioners were included in the study. A self-structured questionnaire was administered after getting consent from the participants. The questionnaire consisted of demographic details, self-reported usage of antibiotics in different clinical situations and questions exploring the practices regarding the use of antibiotics. Data were analyzed using SPSS version 24.0. Results: 87% of the participants prescribed antibiotics in irreversible pulpitis, 53.7% in dry socket and 78.7% in localized periapical abscess. Regarding their practice of antibiotic prescription, 77.8% participants reported the prescription of antibiotics in addition to the dental treatment for early resolution of the symptoms. 73.2 % reported that they fear the spread of infection if they have not prescribed antibiotics and 66.7% reported the use of antibiotics to defer the patient if the provision of treatment was not possible at the time. 68.9% participants reported that they would resort to some different antibiotic in case of persistent dental pain at the follow-up visit. Conclusions: The study shows indiscriminate and inappropriate use of antibiotics by the dentists. A lack of knowledge among the dental practitioners regarding the evidence-based clinical indications for antibiotics was evident.


Guideline on Use of Antibiotic Therapy for Pediatric Dental Patients. Pediatric dental journal. 2016 Oct; 38(6):325-327.

Durkin MJ, Hsueh K, Sallah YH, Feng Q, Jafarzadeh SR, Munshi KD, et al; Centers for Disease Control and Prevention Epicenters. An evaluation of dental antibiotic prescribing practices in the United States. American journal of dentistry. 2017 Dec; 148(12):878-886.e1. doi: 10.1016/j.adaj.2017.07.019.

Lockhart PB, Tampi MP, Abt E, Aminoshariae A, Durkin MJ, Fouad AF, et al. Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association. American journal of dentistry. 2019 Nov; 150(11):906-921.e12. doi: 10.1016/j.adaj.2019.08.020.

Cope AL, Francis NA, Wood F, Chestnutt IG. Antibiotic prescribing in UK general dental practice: a cross-sectional study. Community Dentistry and Oral Epidemiology. 2016 Apr; 44(2):145-53. doi: 10.1111/cdoe.12199.

US Department of Health and Human Services. Antibiotic resistance threats in the United States, 2013. Centers for disease control and prevention. 2013 Apr; 1-13.

Cope AL, Chestnutt IG, Wood F, Francis NA. Dental consultations in UK general practice and antibiotic prescribing rates: a retrospective cohort study. The British journal of general practice. 2016 May; 66(646): e329-36. doi: 10.3399/bjgp16X684757.

Lamont T, Worthington HV, Clarkson JE, Beirne PV. Routine scale and polish for periodontal health in adults. Cochrane database of systematic reviews. 2018 Dec; 12(12):CD004625. doi: 10.1002/14651858.CD004625.pub5.

Fouad AF, Byrne BE, Diogenes AR, Sedgley CM, Cha BY. AAE guidance on the use of systemic antibiotics in endodontics, AAE position statement. 2017.

Carlin K, Löfmark S, Blad L. Swedish Work on Containment of Antibiotic Resistance: Tools, Methods and Experiences. Public Health Agency of Sweden; 2014.

Singh PK. A universal good: How increased health coverage can help beat back antimicrobial resistance. World Health Organization, Regional Office for South-East Asia. 2017.

Ramadan AM, Rikaby OA, Abu-Hammad OA, Dar-Odeh NS. Knowledge and attitudes towards antibiotic prescribing among dentists in Sudan. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2019 Sep;19.

Dar-Odeh NS, Abu-Hammad OA, Al-Omiri MK, Khraisat AS, Shehabi AA. Antibiotic prescribing practices by dentists: a review. Therapeutics and Clinical Risk Management. 2010 Jul; 6:301-6. doi: 10.2147/tcrm. s9736.

Sivaraman SS, Hassan M, Pearson JM. A national survey of pediatric dentists on antibiotic use in children. Pediatric Dentistry. 2013 Nov; 35(7):546-9.

Cope AL, Francis N, Wood F, Chestnutt IG. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. Cochrane database of systematic reviews. 2018 Sep; 9(9):CD010136. doi: 10.1002/14651858.CD010136.pub3.

Agnihotry A, Thompson W, Fedorowicz Z, van Zuuren EJ, Sprakel J. Antibiotic use for irreversible pulpitis. Cochrane database of systematic reviews. 2019 May; 5(5):CD004969. doi: 10.1002/14651858.CD004969.pub5.

Germack M, Sedgley CM, Sabbah W, Whitten B. Antibiotic Use in 2016 by Members of the American Association of Endodontists: Report of a National Survey. Journal of endodontics. 2017 Oct; 43(10):1615-1622. doi: 10.1016/j.joen.2017.05.009.

Matthews DC, Sutherland S, Basrani B. Emergency management of acute apical abscesses in the permanent dentition: a systematic review of the literature. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. 2003.

Marra F, George D, Chong M, Sutherland S, Patrick DM. Antibiotic prescribing by dentists has increased: Why? American journal of dentistry 2016 May; 147(5):320-7. doi: 10.1016/j.adaj.2015.12.014.

Aminoshariae A and Kulild JC. Evidence-based recommendations for antibiotic usage to treat endodontic infections and pain: A systematic review of randomized controlled trials. American journal of dentistry. 2016 Mar; 147(3):186-91. doi: 10.1016/j.adaj.2015.11.002.

Sturrock A, Landes D, Robson T, Bird L, Ojelabi A, Ling J. An audit of antimicrobial prescribing by dental practitioners in the north east of England and Cumbria. BMC Oral Health. 2018 Dec; 18(1):206. doi: 10.1186/s12903-018-0682-4.

Walton WM. What should I do when a patient just wants antibiotics? American journal of dentistry. 2016 May; 147(5):382-3. doi: 10.1016/j.adaj.2016.02.015.

Levin L, Day PF, Hicks L, O'Connell A, Fouad AF, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dental Traumatology. 2020 Aug; 36(4):309-313. doi: 10.1111/edt.12574.

Roberts RM, Bartoces M, Thompson SE, Hicks LA. Antibiotic prescribing by general dentists in the United States, 2013. American journal of dentistry. 2017 Mar; 148(3):172-178.e1. doi: 10.1016/j.adaj.2016.11.020.



DOI: 10.54393/pjhs.v3i04.84
Published: 2022-09-30

How to Cite

Babar, P. . ., Virda, M. ., Haider, A. ., Alamgir, W. ., Afzal, M. ., & Ahmad Khan, R. M. . (2022). An evaluation of antibiotic prescribing practices among dentists in Lahore: A cross-sectional study: Antibiotic Prescribing Practices Among Dentists in Lahore. Pakistan Journal of Health Sciences, 3(04), 23–26.



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