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Impacto da antibioterapia em medicina dentária na emergência de resistências microbianas: revisão integrativa
| Name: | Description: | Size: | Format: | |
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| Projeto de pós-graduação_39746 | 1 MB | Adobe PDF |
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Abstract(s)
Estima-se que 10% dos antibióticos mundialmente utilizados sejam prescritos por médicos dentistas, pelo que é indispensável que estes estejam instruídos quanto às guidelines impostas por organizações de saúde ou associações específicas de áreas de medicina dentária. A incomplacência por parte dos médicos dentistas quanto a estas guidelines dá origem a prescrições antimicrobianas empíricas desnecessárias para as quais não estão aconselhadas ou não são a opção adequada. Devido a este fenómeno, surge um problema muito inquietante que compromete a saúde pública: as resistências microbianas. Estas são um problema porque condicionam a eficácia de antibióticos comumente prescritos em todas as áreas de medicina e, se não forem tomadas medidas urgentes, haverá uma emergência de infeções de bactérias multirresistentes e, consequentemente, um aumento da mortalidade associada.
Por esta razão, esta dissertação tem como objetivos indicar quais os antibióticos que se deve prescrever de acordo com cada área da medicina dentária, respeitando as devidas regras de prescrição, analisar as tendências de prescrição de médicos dentistas e compreender a associação entre prescrição antibiótica inadequada e o aparecimento de resistências microbianas e o seu impacto para a saúde pública.
Para tal, foi realizada uma pesquisa bibliográfica na base de dados PubMed, ScienceDirect e Scielo, recorrendo a palavras-chave e critérios de inclusão e exclusão, resultando em 29 artigos publicados entre 2017 e 2023, que foram agrupados em quatro tópicos principais: 13 sobre epidemiologia de uso e prescrição de antibióticos em medicina dentária, 4 sobre antibioterapia em medicina dentária, 6 sobre a profilaxia antibiótica em medicina dentária e 6 sobre resistência antimicrobiana em medicina dentária.
Verifica-se que muitas prescrições de antibióticos para o tratamento das infeções odontogénicas ainda são injustificadas e, por isso, os médicos dentistas devem realizar uma anamnese completa do paciente e considerar todas as suas possíveis patologias, fazer um diagnóstico o mais preciso possível e prescrever antibioterapia de acordo com as recomendações das agências nacionais e internacionais de saúde, sendo sempre recomendado a utilização de um antibiótico de espectro mais estreito, na dose mais baixa possível para tratar a infeção e durante o mais curto espaço de tempo. Só desta forma se poderá impedir as resistências microbianas.
It is estimated that 10% of the antibiotics used worldwide are prescribed by dentists, so it is essential that they are instructed about the guidelines imposed by health organizations or specific associations in the areas of dentistry. Laxity on the part of dentists regarding these guidelines leads to unnecessary empirical antimicrobial prescriptions for which they are not advised or are not the appropriate option. Due to this phenomenon, a much-feared problem that compromises public health arises: microbial resistance. This is a problem because it conditions the effectiveness of antibiotics commonly prescribed in all areas of medicine and, if urgent measures are not taken, there will be an emergence of infections caused by multidrug-resistant bacteria and, consequently, an increase in associated mortality. For this reason, this dissertation aims to indicate which antibiotics should be prescribed according to each area of dentistry, respecting the proper prescribing rules, analyzing the prescribing trends of dentists, and understanding the association between inadequate antibiotic prescription and the emergence of microbial resistance and its impact on public health. To this end, a literature search was carried out in the PubMed, ScienceDirect, and Scielo databases using keywords and inclusion and exclusion criteria, resulting in 29 articles published between 2017 and 2023, which were grouped into four main topics: 13 on the epidemiology of antibiotic use and prescription in dentistry, 4 on antibiotic therapy in dentistry, 6 on antibiotic prophylaxis in dentistry, and 6 on antimicrobial resistance in dentistry. It was found that many antibiotic prescriptions for the treatment of odontogenic infections are still unjustified, and therefore dentists should perform a complete anamnesis of the patient and consider all possible pathologies, make the most accurate diagnosis possible, and prescribe antibiotic therapy according to the recommendations of national and international health agencies. It is always recommended to use a narrower-spectrum antibiotic, at the lowest possible dose to treat the infection, and for the shortest possible time. This is the only way to prevent microbial resistance.
It is estimated that 10% of the antibiotics used worldwide are prescribed by dentists, so it is essential that they are instructed about the guidelines imposed by health organizations or specific associations in the areas of dentistry. Laxity on the part of dentists regarding these guidelines leads to unnecessary empirical antimicrobial prescriptions for which they are not advised or are not the appropriate option. Due to this phenomenon, a much-feared problem that compromises public health arises: microbial resistance. This is a problem because it conditions the effectiveness of antibiotics commonly prescribed in all areas of medicine and, if urgent measures are not taken, there will be an emergence of infections caused by multidrug-resistant bacteria and, consequently, an increase in associated mortality. For this reason, this dissertation aims to indicate which antibiotics should be prescribed according to each area of dentistry, respecting the proper prescribing rules, analyzing the prescribing trends of dentists, and understanding the association between inadequate antibiotic prescription and the emergence of microbial resistance and its impact on public health. To this end, a literature search was carried out in the PubMed, ScienceDirect, and Scielo databases using keywords and inclusion and exclusion criteria, resulting in 29 articles published between 2017 and 2023, which were grouped into four main topics: 13 on the epidemiology of antibiotic use and prescription in dentistry, 4 on antibiotic therapy in dentistry, 6 on antibiotic prophylaxis in dentistry, and 6 on antimicrobial resistance in dentistry. It was found that many antibiotic prescriptions for the treatment of odontogenic infections are still unjustified, and therefore dentists should perform a complete anamnesis of the patient and consider all possible pathologies, make the most accurate diagnosis possible, and prescribe antibiotic therapy according to the recommendations of national and international health agencies. It is always recommended to use a narrower-spectrum antibiotic, at the lowest possible dose to treat the infection, and for the shortest possible time. This is the only way to prevent microbial resistance.
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Keywords
Antibióticos Resistência aos antibióticos Profilaxia Medicina dentária Resistência bacteriana Antibiotics Antibiotic resistance Prophylaxis Dentistry Bacterial resistance