The knowledge of undergraduate dental students and dentists about antibiotic prophylaxis in patients at risk for infective endocarditis

ABSTRACT Infective Endocarditis (IE) is an infection of the endocardial surface of the heart that is caused by fungi, bacteria or viruses. The high mortality and morbidity rates of IE have encouraged the adoption of preventive strategies. This study investigated the knowledge on the prevention of IE among 2nd, 3rd and 4th-year undergraduate dental students at the Escola Superior São Francisco de Assis (ESFA) and among dentists working in the municipality of Santa Teresa, ES, Brazil. Objective: The rationale for this study was to identify the gaps in their knowledge and raise awareness on the topic. Methods: The study was previously approved by the Research Ethics Committee. The sample consisted of dental students who had completed the Pharmacology for Dentistry course at the ESFA, totaling 35 2nd-year students, 29 3rd-year students, and 36 4th-year students. Thirty dentists registered in the Regional Council of Dentistry of Espírito Santo state, who were working in the municipality of Santa Teresa, ES, Brazil, were also included. All participants were given a questionnaire containing six objective and four subjective questions to assess their knowledge regarding the definition of IE, high-risk patients, dental procedures known to cause bacteremia, recommended dosage regimens for high risk patients, and additional care in the assistance of these patients. The questionnaires’ responses were reviewed following the American Heart Association (AHA) guidelines for disease prevention published in 2007. Results: The analysis of the results revealed a low rate of correct responses among students and dentists. The questions with the lowest rate of correct responses were those addressing the identification of patients at high risk for heart conditions and the dental procedures known to cause bacteremia, with no significant differences between the four groups analyzed (P > 0.05). Third-year dental students presented a frequency of correct responses significantly lower than that of the other groups (P < 0.001), which did not differ from each other. To conclude, all participants demonstrated poor knowledge about the topic, particularly 3rd-year dental students. Conclusion: These results reinforce the need for informative measures to raise awareness and improve the quality of dental care provided to the population.

摘要 感染性心内膜炎（Infective Endocarditis, IE）是由真菌、细菌或病毒引发的心脏心内膜表面感染。该病具有较高的病死率与发病率，促使学界采纳各类预防策略。本研究针对巴西圣埃斯皮里图州圣特雷莎市执业牙医，以及圣方济各高等学院（Escola Superior São Francisco de Assis, ESFA）的大二、大三、大四本科牙科学生的感染性心内膜炎预防认知水平展开调研。
研究目的：本研究旨在明确两类人群在该领域的认知缺口，并提升相关主题的认知水平。
方法：本研究已事先获得研究伦理委员会批准。研究样本包括已修完牙科药理学课程的ESFA牙科学生，其中大二学生35名、大三学生29名、大四学生36名；另纳入30名在巴西圣埃斯皮里图州圣特雷莎市执业、且注册于圣埃斯皮里图州牙科地区委员会的牙医。所有参与者均填写一份问卷，内含6道客观题与4道主观题，用以评估其对感染性心内膜炎定义、高危患者、可引发菌血症的牙科操作、高危患者推荐给药方案，以及此类患者诊疗中额外注意事项的认知水平。问卷作答的评判标准参照2007年美国心脏协会（American Heart Association, AHA）发布的疾病预防指南。
结果：结果分析显示，学生与牙医群体的正确作答率普遍偏低。其中，识别心脏疾病高危患者以及可引发菌血症的牙科操作这两类问题的正确率最低，且四个分析组间无显著差异（P > 0.05）。大三牙科学生的正确作答率显著低于其余各组（P < 0.001），其余各组之间则无显著差异。综上，所有参与者对该主题的认知水平均较差，尤以大三牙科学生为甚。
结论：本研究结果凸显了需通过宣教举措提升公众认知、优化面向人群的牙科诊疗质量的必要性。