Knowledge and compliance of dentists’ and dental students’ with respect to relevant guidelines for prescribing antibiotic prophylaxis for the prevention of infective endocarditis: A systematic review.

Journal of Evidence Based Dental Practice

Available online 8 February 2019

In Press, Accepted Manuscript

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Abstract

Background

It is essential that dental clinicians, including dental students, have sufficient knowledge of and adhere to relevant prophylactic guidelines for the prevention of infective endocarditis. Since the over-prescription of antibiotics contributes to the development of drug resistance, antibiotic stewardship should be at the forefront of patient care. The aim of this review is to determine the level of knowledge and compliance of dentists and dental students to relevant guidelines regarding antibiotic prophylaxis for the prevention of infective endocarditis with respect to relevant guidelines. In addition, we aim to identify the factors that influence the level of knowledge and compliance.

Materials and Methods

The following electronic databases were searched: MEDLINE (OvidSP), Scopus, Web of Science, CINAHL (EBSCOhost) and Informit Health Database. Inclusion criteria were (1) published quantitative studies that assessed dentists’ and/or dental students’ knowledge of and/or compliance with relevant guidelines for the prescribing of antibiotic prophylaxis for the prevention of infective endocarditis; (2) in English; (3) any date. The National Institutes of Health, National Heart, Lung and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to appraise each of the included studies. The required data were collected and formatted to provide a narrative synthesis.

Results

A total of 3,427 articles were identified, 167 full text articles were reviewed; forty-three articles from 37 studies were included. Overall knowledge of guidelines ranged from as low as 1.9% to as high as 100% depending on the detail being examined. No statistically significant difference was found between dental students’ and qualified dentists’ knowledge. Overall compliance with guidelines ranged from 40% to 81%. Respondents’ age and postgraduate training were the variables most associated with dentists’ knowledge of guidelines for infective endocarditis. A limitation of this review is that only quantitative studies in English were assessed.

Conclusion

Knowledge levels of guidelines for antibiotic prophylaxis varied greatly depending on study design, respondent characteristics and time period factors. There is a lack of research published on compliance rates for dentists and dental students with respect to guidelines for the prevention of infective endocarditis.