Undergraduate and Postgraduate Dental Student Knowledge Regarding the Use of Antibiotics in Endodontics: An Online‐Based Survey

AIM: The use of antibiotics in clinical practice is shaped by the adequate knowledge acquired during professional education. The survey aimed to evaluate the knowledge of final-year undergraduate and postgraduate endodontic students regarding the use of antibiotics in endodontic management. METHODOLOGY: The survey was distributed to final year undergraduates and postgraduate endodontic students across 10 dental schools in different countries. The questionnaire included demographic data and assessed the respondents' knowledge of current guidelines and antibiotic use in endodontic scenarios. The survey instrument was validated and piloted prior to distribution. Responses were summarised using frequencies and percentages. Undergraduate and postgraduate students were compared using Pearson's chi-squared or Fisher's exact tests. An institution-equalised sensitivity analysis assessed the influence of institutional participation, and a multivariable logistic generalised estimating equation (GEE) model evaluated factors associated with guideline-concordant responses across clinical scenarios. RESULTS: The overall response rate for undergraduate students was 37.3%, and for postgraduate students was 87.9%. Most respondents recognised that systemic antibiotics were generally not indicated for localised endodontic infections without systemic involvement but were indicated for acute apical abscess with systemic involvement and after replantation of an avulsed permanent tooth. Awareness of the European Society of Endodontology (ESE) guidelines was 49.1% among undergraduate and 82.6% among postgraduate respondents, whereas awareness of the American Association of Endodontists (AAE) guidelines was 70.4% and 91.7%, respectively (p < 0.001 for both comparisons). Awareness of ESE guidelines was independently associated with greater odds of a guideline-concordant response (adjusted OR = 1.39, 95% CI 1.03-1.88; p = 0.029), whereas postgraduate status was not (adjusted OR = 1.36, 95% CI 0.97-1.91; p = 0.070). Institution-equalised estimates supported the qualitative interpretation of most outcomes, although the undergraduate estimate recommending prophylaxis before non-surgical root canal treatment in patients with prosthetic joint replacement within the previous 3 months decreased from 52.5% to 37.2%. CONCLUSIONS: Among respondents from the participating dental schools, knowledge of appropriate antibiotic use was identified across clinical scenarios, with variability particularly in antibiotic selection for patients with true penicillin allergy, use of loading doses and prophylactic antibiotic recommendations. Continued integration of antimicrobial stewardship principles into dental education curricula is warranted.