Antibiotic prescribing for endodontic infections: a survey of dental students in Italy

Aim To determine the knowledge of final year undergraduate students attending Italian universities on the appropriate use of systemic antibiotics for endodontic infections. Methodology Final year dental students from twenty Italian universities completed a one-page questionnaire on antibiotic use for the treatment of endodontic infections. Data were analysed using descriptive statistics and chi-square tests. Results A total of three hundred and three students completed the questionnaire. The average duration of antibiotic prescription proposed by respondents was 5.48 1.06 days. Amoxicillin with clavulanic acid was the first-choice antibiotic (85.2%) followed by amoxicillin alone (13.5%), azithromycin (1.0%) and clarithromycin (0.3%), for patients not allergic to penicillin. Clarithromycin was the first-choice drug for patients with a penicillin allergy (56.1%), followed from azithromycin (31.7%), clindamycin (11.9%) and levofloxacin (0.3%). Alveolar abscess with systemic manifestations was reported as the principal reason to prescribe antibiotics (97.7%) followed by the same condition without systemic manifestations (85.5%). For the scenario of irreversible pulpitis, 5% of students considered antibiotics necessary. Almost 52% of students would prescribe antibiotics for apical acute periodontitis; 29.7% would prescribe antibiotics for chronic apical periodontitis with sinus tract, and 13.5% indicated these drugs for chronic apical periodontitis without sinus tract. Conclusions The results demonstrate that it is necessary to improve the knowledge of Italian students on antibiotics and indications for their use in endodontics.