Qom University of Medical Sciences Journal

acterial infections are common in dental clinical practices. This has led to the frequent use of antibiotics in dentistry as a treatment method. Irrational prescription of drugs causes problems in curing diseases and increases the side effects of drugs, drug interactions, antimicrobial resistance, and treatment costs which imposes heavy burden on the patient and the health system. Dentists often tend to overprescribe antibiotics due to insufficient information about the complications of inappropriate antibiotic administration. Currently, some active bacteria in endodontic infections are resistant to many available antibiotics. Well-designed educational interventions can play an effective role in reducing the unnecessary prescription of antibiotics in medical and dental practices. Different types of teaching methods, including face-to-face or online methods, are used to teach doctors and dentists about how to prescribe antibiotics correctly, each of which has advantages and disadvantages, Due to scant research on the effects of different educational methods on the prescription of antibiotics in dentists in Iran, this study aims to investigate the effect of educational intervention on the prescription of antibiotics in general dentists in Qom, Iran.
Methods
This study was conducted on 134 general dentists in Qom province assigned to two groups of 67. The intervention group participated in a seminar as a retraining course in January 2019. The control group did not participated in the retraining courses and were randomly selected from dental clinics. A checklist was used to collect information. The study variables were age, sex, work experience, types of antibiotics prescribed, drug administration method (orally or injected), drug dose, number of prescribed drugs, and number of prescriptions. The collected data were analyzed in SPSS software, version 26 statistical Descriptive statistics including mean, standard deviation, percentage and frequency were used to report the data, and chi-square test was used to compare the two groups.
Results
The data from 22,418 prescriptions containing antibiotics were examined. In the intervention group, the administration of 500 mg Amoxicillin capsules and 500 mg Penicillin tablets increased significantly after education. In the control group, only the administration of penicillin injection of 1200000 units showed a significant decrease. The most prescribed antibiotic in both groups was Amoxicillin 500 mg capsule. Most of dentists in both groups and at both time points prescribed Amoxicillin 500 mg capsules, followed by Metronidazole 250 mg tablets and Penicillin injection of 800000 units. The most common form of antibiotic administration in both groups and at both time periods was oral administration. In both groups, the number of prescribed antibiotics before and after the intervention had no significant relationship with age and work experience. The number of prescribed antibiotics was significantly related to gender such that it was higher in male dentists than in females. The mean number of prescriptions for each dentist in the intervention group before and after education was 62.73±117 and 72±1.92, respectively (P=0.043), indicating the significant increase of prescriptions after educational intervention. The mean number of prescriptions in the control group before and after education was 96.88 and 100.06, respectively but there was no significant difference (P=0.57). The mean number of prescriptions containing antibiotics before education in the intervention and control groups was 62.7±95.4 and 96.8±134.5, respectively. After education, no significant increase was observed (P=0.09). The mean number of prescriptions containing antibiotics for each dentist in the intervention and control groups were 4.9 and 7.5 per week before educational intervention and 5.6 and 7.7 per week after educational intervention, respectively. In both groups and both time periods, the errors made in prescribing the correct dose of antibiotics was unchanged. There was no significant difference between the two groups in prescription of different types of Azithromycin before and after retraining.
Discussion
It seems that the high number of prescriptions containing antibiotics made by general dentists in Qom province and the increase in their number after retraining, as well as the prescription of drugs such as cephalexin, cefixime and cotrimoxazole, can probably indicate the general dentists’ low level of awareness about the administration and use of antibiotics. Therefore, it can be said that the educational intervention was relatively unsuccessful in achieving its goals, and there is a need to design more effective educational interventions in this field.


Ethical Considerations
Compliance with ethical guidelines
Ethical committee of Qom University of Medical Science IR.MUQ.REC.1398.094.
Funding
Qom University of Medical Science support this study financially.
Authors contributions
 Conceptualization, Methodology, Supervision: Mohammad Mehdizadeh;  Investigation, Resources, Data Curation: Yasamin Barakian;  Review & Editing: Sayedeh Zeinab Sadat Rasool;  Software, Validation, Formal Analysis: Abolfazl Mohammad Beigi; Writing – Original Draft Preparation, Project Administration: Mohammad Aligol;  Review & Editing: Hamid Oureie.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors wish to thank the study participants for their contribution to the research, as well as current and past investigators and staff. The authors would specifically like to thank research deputy of Qom University of Medical Science.