{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:43:46Z","timestamp":1786999426111,"version":"build-2736575974"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"unspecified","delay-in-days":194,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X2510065X_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to identify the factors associated with the use of penicillins as the first-choice antimicrobial in Japan\u2019s dental clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2510065X_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cross-sectional questionnaire-based survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2510065X_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Dental clinics throughout Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2510065X_as4\">\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Dentists at the participating clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2510065X_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Questionnaires were sent to 1,700 dental care facilities in July 2020, and responses were collected until September 2020. The survey gathered data on clinic characteristics, provision of on-site antimicrobial dispensing, choice of antimicrobials, and knowledge regarding antimicrobial resistance (AMR) and infective endocarditis (IE). Descriptive epidemiology and logistic regression analyses were performed to identify the factors associated with on-site dispensing of penicillins and their use as the first-choice antimicrobial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2510065X_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Responses were obtained from 342 (response rate: 20.1 %) dentists from dental clinics. While 93.9% of respondents were aware of the term \u201cAMR,\u201d only 20.8% were familiar with Japan\u2019s National Action Plan on AMR. AMR countermeasures were implemented in 79.4% of clinics, but 58.4% of respondents lacked awareness of IE guidelines. In the multivariable logistic regression analyses, \u201cadherence to IE guidelines\u201d (odds ratio: 2.56,\n                      <jats:italic>P<\/jats:italic>\n                      = .001) and \u201cclinic stocks \u22652 antimicrobials\u201d (5.02,\n                      <jats:italic>P<\/jats:italic>\n                      = .002) were positively associated with on-site dispensing of penicillins. In contrast, \u201cclinic with \u22652 full-time dentists\u201d (odds ratio: .45,\n                      <jats:italic>P<\/jats:italic>\n                      = .033) was negatively associated with the use of penicillins as the first-choice antimicrobial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2510065X_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There was a low awareness of the National Action Plan and IE guidelines among dentists. Enhancing educational activities and fostering environments that facilitate collaborative decision-making regarding antimicrobial use may help to improve antimicrobial stewardship in Japan\u2019s dental clinics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2025.10065","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T12:34:37Z","timestamp":1752496477000},"source":"Crossref","is-referenced-by-count":1,"title":["Factors associated with using penicillins as the first-choice antimicrobial among dentists in Japan: a national cross-sectional study"],"prefix":"10.1017","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6248-336X","authenticated-orcid":false,"given":"Ryuji","family":"Koizumi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4719-651X","authenticated-orcid":false,"given":"Masahiro","family":"Ishikane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7072-2338","authenticated-orcid":false,"given":"Yoshiki","family":"Kusama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5732-846X","authenticated-orcid":false,"given":"Shinya","family":"Tsuzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2979-3449","authenticated-orcid":false,"given":"Yusuke","family":"Asai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-340X","authenticated-orcid":false,"given":"Yasuyuki","family":"Shimada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chika","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Ohmagari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"S2732494X2510065X_ref3","unstructured":"3. 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