Knowledge and perceived confidence regarding the prescription of antibiotics and analgesics among dental students – An institutional-based study

INTRODUCTION

Prescribing was a mandatory skill to be acquired by doctors in nearly all medical specialties.^[1] The wrong prescriptions could lead to a rise in medicolegal problems, aggravation or persistence of illness, unsuccessful treatment, suffering to the patient, and increased cost.^[2] A rational drug prescription refers to the use of the least number of drugs to achieve the best results in the shortest period of time and at the lowest cost possible.^[3-5]

Dental students studied pharmacology in their 2^nd year and were exposed to clinical practice during their third and final years. They often prescribe drugs to the patient under the guidance of professors.^[1] The most commonly recommended drugs in dentistry were non- steroidal anti-inflammatory drugs, local anesthetics, and antibiotics.^[1] Consequently, it was imperative to possess precise information regarding the safe dosages of these medications and their adverse effects. Their lack of knowledge and confidence in their future dental practice will negatively impact their treatment outcomes and make them more likely to face medical and legal issues as a result. Hence, the medication practices occurring in the young population revealed the complex relationship with health, knowledge, and behavior that had to be considered to deliver safe and effective use of medication.^[6]

Prescribing errors are common worldwide. For example, repeated prescribing of antibiotics, which was widespread in Taiwan, often leads to microbial resistance and treatment failure, such as multidrug-resistant tuberculosis.^[7] There was evidence that dentists in Mexico and other countries frequently prescribe medications incorrectly as a result of a lack of precise pharmacological knowledge.^[5]

Thus, two-way dialog and appropriate questioning by medical experts aid in the establishment of treatment objectives and the detection of patient-related drug safety issues.^[8] Effective intervention, however, cannot be made without understanding dental student knowledge of and practices with medications. Numerous researches were conducted on medical students’ prescription knowledge, despite the dearth of literature among dental students. Even if dental students were taught how to prescribe medication in their initial educational modules, their usage of recommending prescriptions in clinical departments needed to be reviewed, comprehended, and assessed. The study was conducted to evaluate the knowledge and perceived confidence of dental students in prescribing antibiotics and analgesics in light of this context.

MATERIAL AND METHODS

RESULTS

The total number of participants was 300. Of these, 229 were female participants and 70 were male participants [Table 1]. Descriptive statistics showed the frequency and proportion of participants who responded about their knowledge and practice of prescribing antibiotics.

The results show that 210 (69%) participants responded that the same dosage of drug could be used for both children and adults [Table 2]. 269 (89%) participants responded that unit dosage form affects efficacy. 291 (96%) participants said that certain drugs can cause side effects if used incorrectly. 242 (81%) participants responded that no drugs should be prescribed during pregnancy.

Table 3 shows that 278 (92%) participants often spend time carefully considering whether antibiotics are needed. 276 (91%) participants informed patients about possible side effects of the drug. 288 (95%) take history of drug allergy before prescribing drug.

DISCUSSION

The study’s goal was to assess the institution’s dental students’ knowledge and perceived confidence regarding drug prescriptions. This study’s objective was to present broad data regarding drug prescriptions among dental students.

Questionnaires were given to the pupils, and the results were assessed. According to the statistics, dentistry students have a good outlook but lack the knowledge and skills needed to take drugs safely. Ninety-seven percent of the students knew that allergies can result from some drugs. In contrast to the results of the study by Doshi et al., most students stated that children and adults may take the same drugs.^[9] According to this study, the majority of students thought that some drugs were unsafe for kids to take and would trigger allergies.

Most pupils knew about side effects, storage, and route of administration. Human health is increasingly at risk from antibiotic resistance. In this study, nearly 88% of students knew about antibiotic resistance. In contrast, a study of medical graduates of medical school in Ireland found low awareness of antibiotic resistance among students.^[10] 13.5% respondents believed that color of the drug influenced its efficacy. Only 35% of respondents knew that size of the pill influenced its efficacy.

The results of the present study showed that most of them follow the ethical guidelines for prescription. Most of them often need time to properly assess whether antibiotics were necessary or not. A study conducted in medical schools in Saudi Arabia and Udaipur, India^[9] arrived a similar conclusion.^[11]

Ninety-five percent of students believed that doctors should consider common criteria such as the patient’s history of adverse drug responses, systemic diseases, pregnancy or nursing history, and previous medication history before prescribing drugs. This implies that before issuing prescriptions, they underwent a rigorous training program.

Despite their limited participation, postgraduate dentistry students demonstrated much higher average knowledge than trainees and undergraduate students, according to the current study. This can be because graduate students continue their clinical training. This supports a study of Iranian medical schools that showed that students had only a limited understanding of antibiotics.^[12]

A limitation of the study includes a reduced sample size and restricted study population. The parameters were confined to antibiotics and analgesics. Other commonly prescribed medications in dentistry including local anesthesia, corticosteroids, antifungals, and antivirals, were not included in the study. Similar studies with larger sample sizes in multispecialty health centers would throw light on the current scenario of drug prescription. This would provide accurate results and understanding of various prescribing patterns in a wider population.

Being confident while prescribing antibiotics and analgesics is a crucial component of dental education. Lack of confidence no longer equates to poor practice but it can still be a stressor that hinders scientific judgment and has a negative impact on the practice’s routine.^[13] In addition to the prescribers, the patients are crucial in managing the antibiotic. Analgesic and antibiotic prescriptions may also be affected by the patients’ knowledge, actions, and attitudes.^[14]

CONCLUSION

In the current study, it was discovered that many respondents had sufficient knowledge and experience, while only a small number had little or no trust in their ability to provide antibiotics and analgesics. A strong foundation in basic medical sciences is essential for developing the art of writing quality prescriptions. Continuing professional educational programs, use of innovative teaching methodology and extensive clinical governance by the faculties adequately trained in prescription writing would improve the quality of prescription writing among undergraduate students This will have a positive impact in their clinical practice.