OBJECTIVES: Resistance to antibiotics is getting worse every day. Antibiotics are commonly prescribed medicines for the prevention and treatment of bacterial infections in dental clinics. Nationally, we are attempting to reduce the use of antibiotics, but this cannot be easily achieved. As a precedent study, we investigated factors affecting antibiotic prescription in dental clinics. METHODS: We analyzed electronic patient records of S dental hospital located in a big city. A total of 12,711 medical records were analyzed. The type of prescribed antibiotic, the prescription rate, and the number of prescription days were analyzed by chi-square test and t-test. Factors associated with the rate of antibiotic prescription were analyzed using logistic regression by dividing the independent variables into four groups: patient characteristics, dentist characteristics, treatment characteristics, and time characteristics. RESULTS: The rate of antibiotic prescription was 91.7% for the first implant surgery and 60.0% for minor operations including incision and drainage. The duration of antibiotic prescription differed according to the sex of the dentist and the type of treatment. The logistic regression analysis showed that the rate of antibiotic prescription was higher in male patients, in older patients, and in female dentists, and decreased with increasing age of the dentist. Compared with basic treatment, the odds ratio of first implant surgery was highest at 102.166 times, minor operation at 18.997, and extraction of impacted tooth at 14.429. CONCLUSIONS: This is the first study to analyze the factors affecting prescription rate of antibiotics in dental clinics. We found that the antibiotic prescription rate was significantly different for each dental treatment. It was necessary to analyze the prescription rate of antibiotics according to the type of treatment. The fact that prescribing antibiotics differed according to dentist characteristics indicated that consistent guidelines need to be established and promoted.
Anti-Bacterial Agents ; Bacterial Infections ; Dental Clinics ; Dentists ; Drainage ; Female ; Humans ; Logistic Models ; Male ; Medical Records ; Odds Ratio ; Prescriptions* ; Tooth, Impacted

No abstract available.
Hemorrhage*

BACKGROUND: Dentist's income is quite variable. We investigate the factors underlying the distribution of dental revenue and dentist income. METHODS: Financial and structural variables of private dental practices(N=13,967) were examined with 2010 Economic Census microdata which include non-insurance revenue. We conducted quantile regression method(QRM) and ordinary least square(OLS) in treating skewness and heteroskedasticity of distributions. The effective estimation for the upper and lower range of distribution becomes possible by QRM. RESULTS: Mid-career dentists are shown to have higher revenue and income. Male dentists achieve the higher revenue and income than female dentists in all quantiles. Group practices show lower income per owner than solo practices significantly. The revenue and income are increased with increasing size of clinics. The high cost in renting the clinic office is found to have a big positive effect on the revenue but a little positive effect on the income. Interestingly the density of dentists shows negative effect on the lowest quantile of the revenue but positive effect on the highest quantile. The lowest quantile of the revenue in the capital areas have the relatively high revenue. The lowest quantile of the income in metropolitan city show higher income than those in other areas significantly. CONCLUSION: The suggested QRM is shown to have more effective and efficient tool in finding out determinants of dentists' revenue and income of our concern. The results of this study are expected to be employed for dentists preparing for the opening practices in their organizational settings and locational selections. The distributional efficiency of dental human resources could be accomplished if policy makers guide dentists with this knowledge.
Administrative Personnel ; Censuses ; Dentists* ; Female ; Group Practice ; Humans ; Male ; Private Practice

Background/Aims: The proper handling of antithrombotics is critical, and this study aimed to assess guideline adherence in the management of antithrombotics before and after endoscopy. Methods: A survey questionnaire was developed. The respondents’ demographic information was included, and the questionnaire was divided into the first section for forceps biopsy, the second for polypectomy, and the third for endoscopic submucosal dissection (ESD) in which aspirin, clopidogrel, combination therapy (aspirin and clopidogrel), warfarin, and direct oral anticoagulants (apixaban) were prescribed to imaginary patients. Results: A total of 415 endoscopists completed this survey (response rate of 6.2%, 415/6,673). The percentage of respondents who chose to proceed with biopsy for patients taking aspirin, those taking clopidogrel, those under combination therapy, those taking warfarin, and those taking apixaban was 89.4%, 74.2%, 61.0%, 38.6%, and 50.4%, respectively. Most respondents answered that they would discontinue aspirin, clopidogrel, and a combination of both drugs for 5 days before polypectomy or ESD (69.4%/76.9%, 83.6%/83.9%, and 53.3%/65.8%, respectively). The answers indicated that warfarin should be discontinued with heparin bridge therapy in high thromboembolic risk patients (polypectomy 70.1%, ESD 73.5%). Regarding apixaban use in polypectomy and ESD, 63.9% and 58.1% of respondents, respectively, chose answers consistent with the guidelines. Conclusions The gap between the guidelines and clinical practice in the management of antithrombotics before and after endoscopy is considerable and should be addressed via educational strategies.

Background/Aims: The mucoprotective drug rebamipide is used to treat gastritis and peptic ulcers. We compared the efficacy of Mucosta Ⓡ (rebamipide 100 mg) and its new formulation, AD-203 (rebamipide 150 mg), in treating erosive gastritis. Methods: This double-blind, active control, noninferiority, multicenter, phase 3 clinical trial randomly assigned 475 patients with endoscopically proven erosive gastritis to two groups: AD-203 twice daily or Mucosta Ⓡ thrice daily for 2 weeks. The intention-to-treat (ITT) analysis included 454 patients (AD-203, n=229; Mucosta Ⓡ , n=225), and the per-protocol (PP) analysis included 439 patients (AD-203, n=224; Mucosta Ⓡ , n=215). The posttreatment assessments included the primary (erosion improvement rate) and secondary endpoints (erosion and edema cure rates; improvement rates of redness, hemorrhage, and gastrointestinal symptoms). Drug-related adverse events were evaluated. Results: According to the ITT analysis, the erosion improvement rates (posttreatment) in AD-203-treated and Mucosta Ⓡ -treated patients were 39.7% and 43.8%, respectively. According to the PP analysis, the erosion improvement rates (posttreatment) in AD-203-treated and Mucosta Ⓡ -treated patients were 39.3% and 43.7%, respectively. The one-sided 97.5% lower limit for the improvement rate difference between the study groups was −4.01% (95% confidence interval [CI], –13.09% to 5.06%) in the ITT analysis and −4.44% (95% CI, –13.65% to 4.78%) in the PP analysis. The groups did not significantly differ in the secondary endpoints in either analysis. Twenty-four AD-203-treated and 20 Mucosta Ⓡ -treated patients reported adverse events but no serious adverse drug reactions; both groups presented similar adverse event rates. Conclusions The new formulation of rebamipide 150 mg (AD-203) twice daily was not inferior to rebamipide 100 mg (Mucosta Ⓡ ) thrice daily. Both formulations showed a similar efficacy in treating erosive gastritis.