Fakülteler / Faculties
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Item Rational Use of Medicine in Dentistry: Do Dentists Prescribe Antibiotics in Appropriate Indications?(2017) Koyuncuoglu, Cenker Z.; Aydin, Mehtap; Kirmizi, N. Ipek; Aydin, Volkan; Aksoy, Mesil; Isli, Fatma; Akici, Ahmet; https://orcid.org/0000-0003-4044-9366; 28462430; HLX-0937-2023There are concerns regarding appropriate use of antibiotics in dentistry practice. Data on dental antibiotic prescribing patterns by dentists is relatively limited. This nationwide study aimed to examine dentists' antibiotic prescriptions in a diagnosis-based manner in Turkey. This retrospective study on utilization of systemic antibiotics for dental problems was based on the national health data of the dentists obtained from Prescription Information System between January 2013 and August 2015. Only those prescriptions containing single diagnosis and at least one systemic antibiotic were included in the study. Antibiotic prescribing was compared by diagnoses and expertise of dentists. A total of 9,293,410 antibiotics were detected in 9,214,956 prescriptions that contained "single diagnosis and at least one antibiotic." The number of antibiotics per prescription was 1.01. "Periapical abscess without sinus" (28.1%), "dental examination" (20.7%), and "dental caries" (16.2%) were the three most common indications in which antibiotics were prescribed by dentists. While only 3.4% of antibiotics were prescribed upon the single and appropriate "cellulitis and abscess of mouth" diagnosis, the remaining 96.6% was prescribed for irrational/uncertain indications. Consistent in all diagnoses, "amoxicillin + enzyme inhibitor" (58.6%) was the mainly prescribed antibiotic. Analysis of the most preferred "amoxicillin + enzyme inhibitor" prescriptions by expertise of dentists showed significantly much higher prescription rates among Group A specialists and Group B specialists (67.0 and 67.8%, respectively) than those in unidentified dental practitioners (58.2%, p < 0.0001). This study showed that dentists prescribed antibiotics in an arbitrary and mostly unnecessary manner. In general, their antibiotic choices for examined diagnoses could be regarded as irrational. These results indicate the urgent need for improvement of rational antibiotic prescribing habits of dentists.Item Investigation of Antibacterial Prescribing Situations in Dentistry Faculties and Other Dental Health Institutions(2017) Kirmizi, N. Ipek; Aydin, Mehtap; Koyuncuoglu, Cenker Z.; Aksoy, Mesil; Kadi, Esma; Alkan, Ali; Akici, Ahmet; https://orcid.org/0000-0003-4044-9366; HLX-0937-2023Objective: The relationship between the institutions where dentists work and their prescribing performance is not known. This study aimed to investigate antibacterial prescribing practices of dentists working in different healthcare institutions. Material and Method: Dentists' antibacterial-containing prescriptions were analyzed by using Prescription Information System (PIS) of Turkish Medicines and Medical Devices Agency. Distribution of antibacterial-containing prescriptions that were prescribed by dentists in universities and other healthcare institutions, starting from January 2013 for a total of 32 months was examined in terms of diagnosis and time periods. Results: It was found that very few number of antibacterials (n=9,952) were prescribed in dentistry faculties (DF) while most of them (n=13,069,333) were prescribed in other dental health institutions (DHI). In both DF and DHI, the most common prescribed antibacterial group was "beta lactam antibacterials-penicillins" (93.7% and 71.3%, respectively) and as an antibacterial agent it was "amoxicillin + enzyme inhibitors" (69.7% and 57.9%, respectively). These were followed by amoxicillin (21.9%) and clindamycin (1.5%) in DF; spiramycin (10.4%) and amoxicillin (9.2%) in DHI. The most frequently prescribed diagnoses were "embedded teeth" and "periapical abscesses-without sinus" in DF and DHI, respectively. Conclusion: This study was the first to reveal similar and different aspects of antibacterial prescribing behaviors between the DF and DHI dentists in Turkey. Although preference of the most common drug was similar, detailed examinations showed variations in antibacterial prescribing behaviors of dentists practicing in universities and other institutions.Item Relative risk of tuberculosis in patients with rheumatic diseases managed with anti-tumour necrosis factor-alpha therapy: A nationwide cohort study(2019) Aydin, Volkan; Akici, Ahmet; Isil, Fatma; Aksoy, Mesil; Aydin, Mehtap; Gursoz, Hakki; 30763469What is known and objective Anti-tumour necrosis factor-alpha (anti-TNF-alpha) therapy is known to raise the risk of granulomatous infections, leading to development of risk management strategies at national or global level. This study aimed to determine the relative risk (RR) of tuberculosis (TB) due to anti-TNF-alpha usage in patients with rheumatologic diseases (RDs) in a nationwide basis. Method This retrospective cohort study included patients with rheumatoid arthritis (RA), ankylosing spondylitis, juvenile idiopathic arthritis or psoriatic arthritis (PsA) that treated with or without anti-TNF-alpha agents, as registered in the national prescription information system between years 2013 and 2015. Two-year RR of TB after anti-TNF-alpha therapy initiation was calculated in this RD population, including main subgroups. Results and discussion The study cohort included 413 500 RD patients, where anti-TNF-alpha(+) arm (n = 2117) had mean age of 41.9 +/- 13.4 years and male distribution of 54.3%. Four patients among anti-TNF-alpha users developed TB compared to 128 patients in anti-TNF-alpha-naive group (189 vs 31 cases per 100 000 patients, respectively), yielding a 2-year RR of 6.07 (95% CI, 2.25-16.42) with an attributable risk of 0.16%. These RRs (95% CI), which were particularly pronounced, were 5.39 (1.69-7.17) in men, 6.12 (2.26-16.55) in adults, and 5.70 (1.41-23.08) in RA and 13.46 (1.58-114.40) in PsA patients. There was no difference between the anti-TNF-alpha users who developed and undeveloped TB regarding drug utilization characteristics, except significantly less immunosuppressive drug exposure in TB patients. What is new and conclusion This study is the first prescription-based nationwide study to suggest an elevated RR of TB in a comparably younger population with a broad spectrum of RDs managed with any approved anti-TNF-alpha drug in Turkey.