{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:28:49Z","timestamp":1785403729724,"version":"3.56.0"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"unspecified","delay-in-days":207,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X2610775X_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Antimicrobial resistance (AMR) is a global public health concern. In Japan, outpatient dental practice frequently involves antimicrobial prescriptions, with oral third-generation cephalosporins prescribed more often than the guideline-recommended amoxicillin. We examined the association between dentists\u2019 multidimensional AMR-related attitudes and selection of oral third-generation cephalosporins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2610775X_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cross-sectional secondary analysis of a questionnaire survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2610775X_as3\">\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>The questionnaire survey was administered to 406 dentists affiliated with the Kagawa Dental Association (November 2024\u2013January 2025), and 111 responses were analyzed (response rate, 27.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2610775X_as4\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The primary outcome was self-reported selection of oral third-generation cephalosporins. AMR attitudes were quantified as overall and domain-specific scores for sense of crisis, self-efficacy, and role awareness. Multivariable logistic regression analysis was performed, adjusting for years of clinical experience, sex, post-treatment prophylactic antimicrobial use, and practice type (in-house vs. external pharmacy dispensing). Domain-specific scores were analyzed separately to avoid multicollinearity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2610775X_as5\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>High overall AMR attitude scores were associated with a low likelihood of selecting third-generation cephalosporins (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.72\u20130.92). Self-efficacy (OR, 0.50; 95% CI, 0.34\u20130.73) and role awareness (OR, 0.59; 95% CI, 0.42\u20130.84) showed strong negative associations. Post-I treatment prophylactic antimicrobial use and practice type involving external pharmacy dispensing were positively (OR, 2.69; 95% CI, 1.07\u20136.75) and negatively (OR, 0.34; 95% CI, 0.15\u20130.77) associated with selection of third-generation cephalosporins, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X2610775X_as6\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Dentists\u2019 AMR-related attitudes, particularly self-efficacy and professional role awareness, were strongly associated with antimicrobial prescription choices. Interventions targeting these factors may promote appropriate antimicrobial use in dental practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2026.10775","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:38:18Z","timestamp":1785145098000},"source":"Crossref","is-referenced-by-count":0,"title":["Association between dentists\u2019 awareness of antimicrobial resistance and selection of oral third-generation cephalosporins: a cross-sectional study"],"prefix":"10.1017","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6252-4366","authenticated-orcid":false,"given":"Tatsuya","family":"Tai","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033sspj46","id-type":"ROR","asserted-by":"publisher"}],"name":"Kagawa University Hospital: Kagawa Daigaku Igakubu Fuzoku Byoin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Motoki","sequence":"additional","affiliation":[{"name":"Kagawa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Kurokawa","sequence":"additional","affiliation":[{"name":"Kagawa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayaka","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Kagawa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Kagawa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Kagawa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Kosaka","sequence":"additional","affiliation":[{"name":"Kagawa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuuichi","family":"Muraki","sequence":"additional","affiliation":[{"name":"Kyoto Pharmaceutical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"S2732494X2610775X_ref9","first-page":"108043","article-title":"Dentists\u2019 knowledge, attitudes, and perceptions of antibiotic prescribing: a systematic review","volume":"185","author":"V\u00e1zquez-Cancela","year":"2024","journal-title":"J Clin Exp Dent"},{"key":"S2732494X2610775X_ref2","unstructured":"2. Government of Japan. National action plan on antimicrobial resistance (AMR) 2016\u20132020 [Internet]. Tokyo: Ministry of Health, Labour and Welfare. 2016. https:\/\/www.mhlw.go.jp\/file\/06-Seisakujouhou-10900000-Kenkoukyoku\/0000138942.pdf. [cited 2025 Sep 5]."},{"key":"S2732494X2610775X_ref8","first-page":"122","article-title":"Cross-sectional study to clarify the status of antimicrobial drug prescription in dental outpatient care","volume":"95","author":"Koizumi","year":"2021","journal-title":"Jpn J Infect Dis"},{"key":"S2732494X2610775X_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlaa092"},{"key":"S2732494X2610775X_ref3","unstructured":"3. AMR Clinical Reference Center. Antimicrobial use surveillance based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) [Internet]. Tokyo: National Center for Global Health and Medicine. 2020. https:\/\/amrcrc.ncgm.go.jp\/surveillance\/010\/20181128172333.html. [cited 2025 Sep 5]."},{"key":"S2732494X2610775X_ref17","doi-asserted-by":"publisher","DOI":"10.17219\/dmp\/159490"},{"key":"S2732494X2610775X_ref7","doi-asserted-by":"publisher","DOI":"10.5649\/jjphcs.48.292"},{"key":"S2732494X2610775X_ref15","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12199"},{"key":"S2732494X2610775X_ref5","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000296"},{"key":"S2732494X2610775X_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq541"},{"key":"S2732494X2610775X_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-019-0882-6"},{"key":"S2732494X2610775X_ref4","volume-title":"JAID\/JSC Guidelines for Infectious Diseases 2023","year":"2023"},{"key":"S2732494X2610775X_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2014.01.004"},{"key":"S2732494X2610775X_ref10","first-page":"112","article-title":"Development and validation of a questionnaire to determine knowledge, attitudes, and practices in antibiotics prescription in dentistry","volume":"31","author":"Angarita-D\u00edaz","year":"2019","journal-title":"Rev Fac Odontol Univ Antioquia"},{"key":"S2732494X2610775X_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/jop.12909"},{"key":"S2732494X2610775X_ref1","unstructured":"1. World Health Organization. Global action plan on antimicrobial resistance [Internet]. Geneva: World Health Organization. 2015. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/193736\/9789241509763_eng.pdf. [cited 2025 Sep 5]."},{"key":"S2732494X2610775X_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2018.05.034"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X2610775X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:38:19Z","timestamp":1785145099000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X2610775X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S2732494X2610775X"],"URL":"https:\/\/doi.org\/10.1017\/ash.2026.10775","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e230"}}