Antibiotics for Prophylaxis of Infective Endocarditis in Pediatric Patients: Knowledge and Prescribing Practices Between Italian Dentists

Background: In pediatric dental care, antibiotics are routinely prescribed for both therapeutic and preventive purposes. Their use is primarily indicated for the management of widespread dental or oral infections, in conjunction with appropriate clinical treatment. Additionally, antibiotics are administered to prevent infective endocarditis (IE) in patients identified as being at increased risk. The present study aimed to evaluate the knowledge and prescribing practices of Italian dentists regarding antibiotic use in pediatric patients through an anonymous online questionnaire. Methods: A specifically designed questionnaire was electronically distributed to a group of Italian dentists. The questionnaire included three sections: demographic data, general knowledge on antibiotic prescribing, and IE prophylaxis in pediatric dentistry. Data were analyzed using appropriate statistical methods. Results: The study included 242 Italian dentists. Only a limited number of statistically significant differences were observed between specialists in pediatric dentistry and general dentists or those with other specializations, as well as between practitioners who mainly treat pediatric patients and those who predominantly treat adults. Regarding antibiotic prophylaxis for IE, most respondents identified amoxicillin as the first-line antibiotic for pediatric patients without penicillin allergy, whereas nearly 30% indicated clindamycin for patients with penicillin allergy. The knowledge about the dosage of assumption of the antibiotic of choice and the timing of administration of the antibiotic prophylaxis were considered as not sufficient. Conclusions: Important gaps remain in dentists’ knowledge of current guidelines for IE prophylaxis, particularly regarding drug dosage and administration. Increased awareness of updated recommendations and potential adverse effects of alternative antibiotics, such as clindamycin, is needed.