Knowledge, attitude, and practice (KAP) of third year dental students regarding antibiotic prophylaxis

Geist, Shin-Mey Rose Yin, and Jerek Bradford-Petrous

The purpose of this survey is to evaluate third year dental students’ knowledge, attitude, and practice (KAP) of antibiotic prophylaxis. The results are used to adjust teaching methods and assist in formulating clinical protocols in this aspect.

 

Antibiotic prophylaxis (AP) before dental procedure to prevent infective endocarditis (IE) has been a non-evidence based practice for more than 50 years. The American Heart Association has been the major driving force in this aspect and as a result, dentists and public have been led to believe it is a standard of care in spite of the lack of supportive evidence to demonstrate patients’ benefit. As medicine and dentistry increasingly move toward evidence based practice, the existence of such non-evidence based guidelines hinder evidence based dental education and compromise the quality of dental care. The American Heart Association issued an evidence supported, clearly written guideline, with input from multiple disciplines, on prevention of IE in 2007. This new guideline not only reversed the overuse of antibiotics, it also ended a major non-evidence based AP practice used by many dentists.   In implementing this new guideline, both students and faculty were introduced to the new concept and details of the guideline immediately after the releasing date. A survey was given to the third year students 6 months after entering the clinic and 9 months after being introduced to this current set of evidence-based guidelines in the Oral Diagnosis/Treatment Planning course. The result of this survey showed that although 70% of students expressed a high level of understanding of the guideline (7 and above on the scale of 1-10 with 10 being the highest level), clinical practice showed otherwise. Only 30% of the students had patients who were given AP.  40% of the AP prescriptions given to prevent IE were not based on the current guideline. In the implementation of the current guideline and the practice of evidence based dentistry, there is a gap between didactic and clinical teaching. Strategies and efforts are planned to narrow this gap after the survey.