Abstract：
BACKGROUND: Antimicrobial resistance is both a global public health and patient safety problem driven by overprescribing of antibiotic and other antimicrobial drugs. To conserve the effectiveness of antibiotics for future generations, antibiotic stewardship approaches to using them only where appropriate and necessary are advocated. Dentistry accounts for about 10% of antibiotic prescriptions across global healthcare, with 80% not in accordance with guidance in some countries. Core outcome sets enable the results of studies to be compared in order to maximise the value which can be derived from them. The aim of this study is to develop an international consensus on a core outcome set for dental antibiotic stewardship.
METHODS: Consensus on outcomes which are critical for inclusion in the core outcome set for dental antibiotic stewardship will be sought through two rounds of a Delphi survey (using the DelphiManager online system) followed by a final online consensus meeting. Thirty participants will be recruited to the Delphi Panel from across three stakeholder groups: ten dentists, ten academics and ten adults experienced with dental antibiotics as either a patient or parent/carer of a patient who has been prescribed them. Consensus will be achieved if more than 70% of the panel agree that an outcome is critical, with at least one from each stakeholder group in agreement. A long-list of candidate core outcomes has been developed from previously published studies with additions recommended by the steering group. The steering group will oversee development of the core outcome set and includes people from around the world with experience of dental antibiotics: clinicians, researchers and people with experience of being prescribed dental antibiotics and/or surviving an antibiotic resistant infection.
CONCLUSIONS: To date, few studies of dental antibiotic stewardship have been published. Internationally, dental antibiotic guidelines and patterns of use vary widely, so a core outcome set is particularly important to facilitate meaningful comparisons between studies. This core outcome set will encompass antibiotic prescribing for both therapeutic indications, such as for people with acute infections, and for prophylactic indications, such as the prevention of distant site infections (like infective endocarditis) following dental procedures.
METHODS: Consensus on outcomes which are critical for inclusion in the core outcome set for dental antibiotic stewardship will be sought through two rounds of a Delphi survey (using the DelphiManager online system) followed by a final online consensus meeting. Thirty participants will be recruited to the Delphi Panel from across three stakeholder groups: ten dentists, ten academics and ten adults experienced with dental antibiotics as either a patient or parent/carer of a patient who has been prescribed them. Consensus will be achieved if more than 70% of the panel agree that an outcome is critical, with at least one from each stakeholder group in agreement. A long-list of candidate core outcomes has been developed from previously published studies with additions recommended by the steering group. The steering group will oversee development of the core outcome set and includes people from around the world with experience of dental antibiotics: clinicians, researchers and people with experience of being prescribed dental antibiotics and/or surviving an antibiotic resistant infection.
CONCLUSIONS: To date, few studies of dental antibiotic stewardship have been published. Internationally, dental antibiotic guidelines and patterns of use vary widely, so a core outcome set is particularly important to facilitate meaningful comparisons between studies. This core outcome set will encompass antibiotic prescribing for both therapeutic indications, such as for people with acute infections, and for prophylactic indications, such as the prevention of distant site infections (like infective endocarditis) following dental procedures.
摘要：
背景：抗生素耐药性是由抗生素和其他抗菌药物的过度处方导致的全球公共卫生和患者安全问题。为了保护抗生素对后代的有效性，提倡仅在适当和必要的情况下使用抗生素管理方法。牙科约占全球医疗保健领域抗生素处方的10%，80%不符合一些国家的指导。核心结果集使研究结果能够进行比较，以最大化可以从中得出的价值。这项研究的目的是就牙科抗生素管理的核心结果集达成国际共识。
方法：将通过两轮Delphi调查（使用DelphiManager在线系统），然后进行最终的在线共识会议，以寻求对纳入牙科抗生素管理核心结果集至关重要的结果的共识。30名参与者将从三个利益相关者团体中招募到德尔福小组：十名牙医，10名学者和10名成年人作为患者或被处方的患者的父母/照顾者使用牙科抗生素。如果超过70％的小组成员同意结果至关重要，将达成共识，每个利益相关者团体至少有一个人同意。从先前发表的研究中已经开发了一长串候选核心结果，并补充了指导小组的建议。指导小组将监督核心结果集的开发，并包括来自世界各地的具有牙科抗生素经验的人：临床医生，研究人员和有处方牙科抗生素和/或抗生素耐药感染幸存经验的人。
结论：迄今为止，很少有关于牙科抗生素管理的研究发表。国际上,牙科抗生素指南和使用模式差异很大，因此，核心结果集对促进研究之间有意义的比较尤为重要。这个核心结果集将包括两种治疗适应症的抗生素处方，比如急性感染的人，对于预防性适应症，如预防牙科手术后的远处感染（如感染性心内膜炎）。
方法：将通过两轮Delphi调查（使用DelphiManager在线系统），然后进行最终的在线共识会议，以寻求对纳入牙科抗生素管理核心结果集至关重要的结果的共识。30名参与者将从三个利益相关者团体中招募到德尔福小组：十名牙医，10名学者和10名成年人作为患者或被处方的患者的父母/照顾者使用牙科抗生素。如果超过70％的小组成员同意结果至关重要，将达成共识，每个利益相关者团体至少有一个人同意。从先前发表的研究中已经开发了一长串候选核心结果，并补充了指导小组的建议。指导小组将监督核心结果集的开发，并包括来自世界各地的具有牙科抗生素经验的人：临床医生，研究人员和有处方牙科抗生素和/或抗生素耐药感染幸存经验的人。
结论：迄今为止，很少有关于牙科抗生素管理的研究发表。国际上,牙科抗生素指南和使用模式差异很大，因此，核心结果集对促进研究之间有意义的比较尤为重要。这个核心结果集将包括两种治疗适应症的抗生素处方，比如急性感染的人，对于预防性适应症，如预防牙科手术后的远处感染（如感染性心内膜炎）。
