Knowledge and Attitudes Towards Antibiotic Prescribing Among Dentists in Sudan

AbdelRahman Murtada Ramadan, Omer AbdelKariem Al Rikaby, Osama Abdalla Abu-Hammad, Najla Saeed Dar-Odeh


Objective:To evaluate antibiotic prescribing practices of dentists working in a major teaching hospital in Sudan, and to assess the need for establishing education programmes to enhance dentists’ awareness of antibiotic use. Material and Methods:A cross-sectional study was carried out by distributing an anonymous self-administered questionnaire to a convenience sample of dental practitioners at major teaching hospital in Khartoum/Sudan. The questionnaire investigated knowledge and attitudes of participants in relation to antibiotic prescribing in dental practice. Results:One hundred out of 135 dental practitioners working at the hospital participated in the survey with 48 males and 52 females. Most of the participants (N=44) did not specify their preferable drug reference, while 32 participants specified British National Formulary, and the practice was significantly associated with a higher professional rank (p<0.001). Metronidazole was the most frequently cited antibiotic for dentofacial infections (N=73) and Acute Necrotizing Ulcerative Gingivitis (N=56), while amoxicillin was the most frequently cited antibiotic for dento-alveolar infections and infective endocarditis prophylaxis (N=88 and N=47, respectively). Conclusion:Undergraduate, as well as postgraduate courses,, are required in Sudan to provide up-to-date orientation on antibiotic use, and to increase awareness of dentists about antibiotic prescribing.


Drug Prescriptions; Anti-Bacterial Agents; Focal Infection, Dental.

Full Text:



Dar-Odeh NS, Al-Beyari M, Abu-Hammad OA. The role of antifungal drugs in the management of denture-associated stomatitis. Int Arab J Antimicrob Agents 2012; 2(1):1-5.

Al-Humaidi SF, Dar-Odeh NS, Alnazzawi A, Kutkut A, Hudieb M, Abu-Hammad O. Volatile sulphur compounds in exhaled air of dental students smoking the waterpipe: A nested case control study. Minerva Stomatol 2017; 66(4):157-62.

Dar-Odeh N, Fadel HT, Abu-Hammad S, Abdeljawad R, Abu-Hammad OA. Antibiotic prescribing for Oro-facial infections in the paediatric outpatient: A review. Antibiotics 2018; 7(2):E38.

Dar-Odeh NS, Othman B, Bahabri RH, Alnazzawi AA, Borzangy SS, Fadel HT, Alolayan AB, Abu-Hammad OA. Antibiotic self-medication for oral conditions: Characteristics and associated factors. Pesqui Bras Odontopediatria Clin Integr 2018; 18(1):e3890.

Salako NO, Rotimi VO, Adib SM, Al-Mutawa S. Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait. J Dent 2004; 32(7):503-9.

Moloney J, Stassen LFA. Pericoronitis: Treatment and a clinical dilemma. J Ir Dent Assoc 2009; 55(4)190-2.

Jayadev M, Karunakar P, Vishwanath B, Chinmayi SS, Siddhartha P, Chaitanya B. Knowledge and pattern of antibiotic and non-narcotic analgesic prescription for pulpal and periapical pathologies - A survey among dentists. J Clin Diagnostic Res 2014; 8(7):ZC10-4.

Oberoi SS, Dhingra C, Sharma G, Sardana D. Antibiotics in dental practice: How justified are we. Int Dent J 2015; 65(1):4-10.

Al-Haroni M, Skaug N. Knowledge of prescribing antimicrobials among Yemeni general dentists. Acta Odontol Scand 2006; 64(5):274-80.

Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States. Available at: [Accessed on June 01, 2018].

Norris P, Chamberlain K, Dew K, Gabe J, Hodgetts D, Madden H. Public beliefs about antibiotics, infection and resistance: A qualitative study. Antibiotics 2013; 2(4):465-76.

Ferguson J, McEwen J, Al-Ajmi H, Purkins L, Colman PJ, Willavize SA. A comparison of the photosensitizing potential of trovafloxacin with that of other quinolones in healthy subjects. J Antimicrob Chemother 2000; 45(4):503-9.

Droste JH, Wieringa MH, Weyler JJ, Nelen VJ, Vermeire PA, Van Bever HP. Does the use of antibiotics in early childhood increase the risk of asthma and allergic disease? Clin Exp Allergy 2000; 30(11):1547-53.

Yallapragada SG, Nash CB, Robinson DT. Early-life exposure to antibiotics, alterations in the intestinal microbiome, and risk of metabolic disease in children and adults. Pediatr Ann 2015; 44(11):e265-9.

Hong L, Levy SM, Warren JJ, Dawson DV, Bergus GR, Wefel JS. Association of amoxicillin use during early childhood with developmental tooth enamel defects. Arch Pediatr Adolesc Med 2005; 159(10):943-8.

Adeyemo WL, Oderinu OH, Olojede ACO, Ayodele AOS, Fashina AA. Nigerian dentists’ knowledge of the current guidelines for preventing infective endocarditis. Community Dent Health 2011; 28(2):178-81.

Lalloo R, Solanki G, Ramphoma K, Myburgh NG. Antibiotic-prescribing patterns of South African dental practitioners following tooth extractions. J Investig Clin Dent 2016; 8(4): e12247.

National Institute for Health and Clinical Excellence. Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. Available at: [Accessed on January 9, 2018].

Thornhill MH, Lockhart PB, Prendergast B, Chambers JB, Shanson D. NICE and antibiotic prophylaxis to prevent endocarditis. Br Dent J 2015; 218(11):619-21.

National Institute for Health and Clinical Excellence. NICE Clinical Guidelines, No. 64. Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. London; 2008. Available at: [Accessed on January 9, 2018].

Allen U. Infective endocarditis: Updated guidelines. Can J Infect Dis Med Microbiol 2010; 21(2): 74–77.

N. S. Dar-Odeh et al. Prescribing Antibiotics for pediatric dental patients in Jordan; knowledge and attitudes of dentists. Int Arab J Antimicrob Agents 2013; 3(3):1-4.

Seymour RA, Hogg SD. Antibiotics and chemoprophylaxis. Periodontol 2000 2008; 46:80-108.

Herrera D, Alonso B, de Arriba L, Santa Cruz I, Serrano C, Sanz M. Acute periodontal lesions. Periodontol 2000 2014; 65(1):149-77.

Morales MP, Carvallo AP, Espinosa KA, Murillo EE. A young man with myelosuppression caused by clindamycin: A case report. J Med Case Rep 2014; 8:7.

Kandula S, Burke WS, Goldfarb JN. Clindamycin-induced Sweet syndrome. J Am Acad Dermatol 2010; 62(5):898-900.

Bulloch MN, Baccas JT, Arnold S. Clindamycin-induced hypersensitivity reaction. Infection 2016; 44(3):357-9.

Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis 2012; 15;55(10):1279-82.

Huang C, Lai J, Huang I, Chen P, Wang H, Shiau Y, Cheng Y, Hsieh L, Chang S, Lauderdale TY. Epidemiology and molecular characterization of macrolide-resistant Streptococcus pyogenes in Taiwan. J Clin Microbiol 2014; 52(2):508-16.

Salah R, Dar-Odeh N, Abu Hammad O, Shehabi AA. Prevalence of putative virulence factors and antimicrobial susceptibility of Enterococcus faecalis isolates from patients with dental diseases. BMC Oral Health 2008; 8:17.

Abu-zineh RF, Dar-odeh NS, Shehabi AA. Macrolide resistance genes and virulence factors of common viridans Streptococci species colonizing oral cavities of patients in Jordan. Oral Health Dent Manag 2015; 14(6):337-41.

Sivaraman SS, Hassan M, Pearson JM. A national survey of pediatric dentists on antibiotic use in children. Pediatr Dent 2013; 35(7):546-9.

Gu Y, Lee H, Napolitano N, Clemens M, Zhang Y, Sorsa T et al. 4-methoxycarbonyl curcumin: A unique inhibitor of both inflammatory mediators and periodontal inflammation. Mediators Inflamm 2013; Article ID 329740.

Froum SJ, Weinberg MA. An Evaluation of Antibiotic Use in Periodontal and Implant Practices. Int J Periodontics Restorative Dent 2015; 35(4):481-7.

Sollecito TP, Abt E, Lockhart PB, Truelove E, Paumier TM, Tracy SL, Tampi M, Beltrán-Aguilar ED, Frantsve-Hawley J. The use of prophylactic antibiotics prior to Dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners-a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2015; 146(1):11-16.e8.