Literature DB >> 17711478

Incomplete adherence to an adjunctive systemic antibiotic regimen decreases clinical outcomes in generalized aggressive periodontitis patients: a pilot retrospective study.

Adrian Guerrero1, Jose J Echeverría, Maurizio S Tonetti.   

Abstract

AIM: The objective of this study was to explore the effect of incomplete adherence to the prescribed antibiotic regimen, amoxicillin and metronidazole, in the non-surgical treatment of generalized aggressive periodontitis (GAP).
METHODS: This retrospective study included 18 GAP subjects who received a conventional course of full-mouth non-surgical periodontal treatment using machine-driven and hand instruments and an adjunctive course of systemic antibiotics (500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days). Clinical parameters were collected at baseline and at 2 months post-treatment. Self-reported adherence to the prescribed medication regimen was recorded at 2 months.
RESULTS: All clinical parameters, except for the mean clinical attachment level (CAL) in sites with initial probing pocket depth (PPD) < or = 3 mm, improved at 2 months in all subjects. PPD reduction was 3.7 mm [95% confidence interval (CI) 3.2, 4.3 mm] in deep pockets (> or = 7 mm) and 2.2 mm (95% CI 1.9, 2.4 mm) in moderate pockets (4-6 mm), while CAL gain was 2.2 mm (95% CI 1.7, 2.6 mm) and 1.2 mm (95% CI 0.8, 1.5 mm), respectively. However, only 11 subjects (61.1%) reported full adherence to the medication. In deep pockets (> or = 7 mm), the difference between an adherent and non-adherent/partially adherent subject was 0.9 mm (95% CI 0.1, 1.7 mm, ancova, p=0.027) in PPD reduction and 0.8 mm (95% CI -0.2, 1.9, p=0.129) in CAL gain at 2 months. In moderate pockets (4-6 mm) this difference was smaller in magnitude: 0.4 mm (95% CI 0.1, 0.9 mm, p=0.036) in PPD reduction and 0.2 mm (95% CI -0.3, 0.9 mm, p=0.332) in CAL gain.
CONCLUSIONS: Within the limits of this design, these data suggest that incomplete adherence to a 7-day adjunctive course of systemic metronidazole and amoxicillin is associated with decreased clinical outcomes in subjects with generalized aggressive periodontitis.

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Year:  2007        PMID: 17711478     DOI: 10.1111/j.1600-051X.2007.01130.x

Source DB:  PubMed          Journal:  J Clin Periodontol        ISSN: 0303-6979            Impact factor:   8.728


  8 in total

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Review 2.  Non-surgical periodontal therapy supplemented with systemically administered azithromycin: a systematic review of RCTs.

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3.  Long-term clinical response to treatment and maintenance of localized aggressive periodontitis: a cohort study.

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6.  Role of antibiotics in generalized aggressive periodontitis: A review of clinical trials in humans.

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7.  Effect of nonsurgical periodontal treatment in conjunction with either systemic administration of amoxicillin and metronidazole or additional photodynamic therapy on the concentration of matrix metalloproteinases 8 and 9 in gingival crevicular fluid in patients with aggressive periodontitis.

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Review 8.  The concomitant administration of systemic amoxicillin and metronidazole compared to scaling and root planing alone in treating periodontitis: =a systematic review=.

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