Research on the effects of pharmacist intervention for the drug therapy in dentistry

• 資料種別: 博士論文
• タイトル: Research on the effects of pharmacist intervention for the drug therapy in dentistry
• 著者・編者: Yoshida, Kensuke
• 著者標目: Yoshida, Kensuke
• 出版年月日等: 2021-09-21
• 出版年（W3CDTF）: 2021-09-21
• 並列タイトル等: 歯科領域における薬物療法への薬剤師の介入効果に関する研究
• 授与機関名: 新潟大学
• 授与年月日: 2021-09-21
• 授与年月日（W3CDTF）: 2021-09-21
• 報告番号: 甲第4947号
• 学位: 博士（歯学）
• 博論授与番号: 甲第4947号
• 本文の言語コード: eng
• 著者別名: 吉田, 謙介
• 件名標目: Ordinary tooth extraction; Mandibular wisdom tooth extraction; Oral antimicrobial prophylaxis; Surgical site infection (SSI); Dental outpatient clinic; Antimicrobial stewardship program (ASP); Mandibular third molar surgery; Prospective cohort study
• 対象利用者: 一般
• 一般注記: Introduction: We investigated the use of oral antibiotics (OA) and surgical site infection (SSI) related to extractions of ordinary teeth and mandibular wisdom teeth in a dental outpatient clinic from January 2015 to December 2019. Methods: The following information were surveyed: (1) presence/absence of OA, (2) timing, (3) type, (4) administration period, and (5) SSI rates. Results: The use of OA during ordinary tooth extraction decreased from 68.3% to 41.3%, but SSI rate did not change during this period of time. Total SSI rate was 0.8% (122/14,832) on average. For mandibular wisdom tooth extraction, preoperative administration of third-generation cephalosporins decreased from 70.4% to 0.3% while that of penicillin (AMPC) increased from 0% to 98%. SSI rate was not changed after these improvements. Total SSI rate was 3.5% (180/5106) on average. The duration of OA was slightly decreased to two days in 2018 and 2019, and it was found that there was no significant difference in SSI rates between 2- and 3-day durations. Preoperative administration had 0.37 odds ratio (OR) (95% confidence interval (95%CI): 0.22-0.63) of SSI compared with postoperative administration. AMPC had 0.76 OR (95% CI: 0.55-1.04) of SSI compared with Third-generation cephalosporins and others. Timing of OA was P < 0.01. Conclusions: SSI rates did not change over time, administration period of OA decreased and the use of AMPC increased. Therefore, it seems necessary to continue to investigate the effects of SSI risk factors proactively in the future and to make efforts in the advocacy of appropriate antimicrobial use.Introduction: According to the guidelines, the dosage for mandibular wisdom tooth extraction (MWTE) varies within the administration period. There is a 24-fold difference between the minimum and maximum doses. If an appropriate antimicrobial can be administered without increasing incidence of surgical site infection (SSI), it may lead to a global action plan on antimicrobial resistance (AMR). Therefore, we prospectively surveyed incidence of SSI post-operatively and use of oral antibiotics (OA) for MWTE. Methods: Subjects were patients who underwent MWTE in our dental outpatient clinic from May 2019 to April 2020. Two groups were formed depending on type of administration period they received: 24 h and 48 h after surgery. The following information was collected: (1) patient factors (age, gender, body mass index, presence/absence of preoperative medication, diagnosis, impacted wisdom tooth status; (2) surgical factors (operative time, presence/absence of closure, presence/absence of hemostat, doctor career, type and frequency of painkiller); (3) relationship between administration period of OA and SSI occurrence; and (4) details of SSI. Results: Three hundred forty subjects were analyzed, all of which used amoxicillin. There were 106 cases in 24 h group and 234 cases in 48 h group. The total incidence of SSI was 1.1% (4/340 cases), with 0.9% (1/106 cases) in 24 h group and 1.3% (3/234 cases) in 48 h group; there was no difference between the two groups. Conclusion: Our study suggests that amoxicillin (250 mg/dose every 8 h x 3 doses beginning 1 h before surgery) might be sufficient in preventing SSI in Japanese dental patients without SSI risk factors.; Clinico-statistical Survey of Oral Antimicrobial Prophylaxis and Surgical Site Infection Regarding Ordinary Tooth Extraction and Mandibular Wisdom Tooth Extraction in the Dental Outpatient Clinic. Journal of Infection and Chemotherapy. 2021, 27(2), 192-197. https://doi.org/10.1016/j.jiac.2020.08.022 【○!C】 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.; Comparison between the Prophylactic Effects of Amoxicillin 24 and 48 hours pre-operatively on Surgical Site Infections in Japanese Patients with Impacted Mandibular Third Molars : A Prospective Cohort Study. Journal of Infection and Chemotherapy. 2021, 27(6), 845-851. https://doi.org/10.1016/j.jiac.2021.01.018 【○!C】 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).; 新大院博(歯)第497号
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• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2022-06-05T18:01:14+09:00
• 記録形式（IMT）: application/pdf
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• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://hdl.handle.net/10191/0002000446; https://niigata-u.repo.nii.ac.jp/records/2000446
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp