Adjunctive azithromycin in the treatment of aggressive periodontitis: Microbiological findings of a 12-month randomized clinical trial

Haas, Alex Nogueira; Silva-Boghossian, Carina Maciel; Colombo, Ana Paula Vieira; Susin, Cristiano; Albandar, Jasim M.; Oppermann, Rui Vicente; Rösing, Cassiano Kuchenbecker

doi:10.1016/j.jdent.2012.03.004

Cited by 27 publications

(34 citation statements)

References 39 publications

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“…Some clinical reports indicated the similar results (Han et al, 2012, Haas et al, 2012). With respect to colony‐forming ability of the samples obtained from organ culture infection models treated with test antibiotics, the combination of AMX or CDR and MTZ effectively treated all bacterial combinations that we tested (Table 2).…”

Section: Discussionsupporting

confidence: 58%

Antibiotic effects against periodontal bacteria in organ cultured tissue

Takeshita

Haraguchi

Miura

et al. 2016

Clinical & Exp Dental Res

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Mechanical reduction of infectious bacteria by using physical instruments is considered the principal therapeutic strategy for periodontal disease; addition of antibiotics is adjunctive. However, local antibiotic treatment, combined with conventional mechanical debridement, has recently been shown to be more effective in periodontitis subjects with type 2 diabetes. This suggests that some bacteria may invade the inflamed inner gingival epithelium, and mechanical debridement alone will be unable to reduce these bacteria completely. Therefore, we tried to establish infected organ culture models that mimic the inner gingival epithelium and aimed to see the effects of antibiotics in these established models. Mouse dorsal skin epithelia were isolated, and periodontal bacteria were injected into the epithelia. Infected epithelia were incubated with test antibiotics, and colony‐forming ability was evaluated. Results indicated that effective antibiotics differed according to injected bacteria and the bacterial combinations tested. Overall, in organ culture model, the combination of amoxicillin or cefdinir and metronidazole compensate for the effects of less effective bacterial combinations on each other. This in vitro study would suggest effective periodontal treatment regimens, especially for severe periodontitis.

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Section: Discussionsupporting

confidence: 58%

Antibiotic effects against periodontal bacteria in organ cultured tissue

Takeshita

Haraguchi

Miura

et al. 2016

Clinical & Exp Dental Res

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“…Analysis of the abstracts resulted in 95 potential articles. In the third phase, the full text articles of the remaining 95 articles were evaluated, of which 40 did not pass the inclusion criteria (Table ). Another 12 articles were excluded because they were about patients with aggressive periodontitis.…”

Section: Resultsmentioning

confidence: 99%

Non‐surgical periodontal therapy with systemic antibiotics in patients with untreated chronic periodontitis: a systematic review and meta‐analysis

Keestra

Grosjean

Coucke

et al. 2014

J of Periodontal Research

146

137

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Systemic antibiotics combined with SRP offer additional clinical improvements compared to SRP alone. Although there were no statistically significant differences, there was a trend that for initially moderate and deep pockets, metronidazole or metronidazole combined with amoxicillin, resulted in clinical improvements that were more pronounced over doxycycline or azithromycin. Additionally, there was a trend that the magnitude of the clinical benefit became smaller over time (1 year).

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“…41 However, the improved clinical outcomes produced by adjunctive AZM have not always been associated with significant suppression of subgingival pathogens. Although some studies have shown that AZM suppresses periodontal pathogens, 40,42 others either did not observe a significant adjunctive effect 43 or did not conduct a statistical analysis of microbiologic data. 44 …”

Section: Discussionmentioning

confidence: 99%

Azithromycin Enhances Phagocytic Killing of Aggregatibacter actinomycetemcomitans Y4 by Human Neutrophils

Lai

Schibler

Walters

2015

Journal of Periodontology

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Background Aggregatibacter actinomycetemcomitans resists killing by neutrophils and is inhibited by azithromycin (AZM) and amoxicillin (AMX). AZM actively concentrates inside host cells, whereas AMX enters by diffusion. The present study is conducted to determine whether AZM is more effective than AMX at enhancing phagocytic killing of A. actinomycetemcomitans by neutrophils. Methods Killing assays were conducted in the presence of either 2 μg/mL AZM or 16 μg/mL AMX (equipotent against A. actinomycetemcomitans). Neutrophils were loaded by incubation with the appropriate antibiotic. Opsonized A. actinomycetemcomitans strain Y4 was incubated with the indicated antibiotic alone, with loaded neutrophils and antibiotic, or with control neutrophils (without antibiotic) at multiplicities of infection (MOIs) of 30 and 90 bacteria per neutrophil. Results Neutrophil incubation with 2 μg/mL AZM yielded an intracellular concentration of 10 μg/mL. At an MOI of 30, neutrophils loaded with AZM failed to kill significantly more bacteria than control neutrophils during the 60- and 90-minute assay periods. At an MOI of 90, neutrophils loaded with AZM killed significantly more bacteria than either AZM alone or control neutrophils during 60- and 90-minute incubations (P <0.05), and killed significantly more bacteria after 90 minutes than the sum of the killing produced by AZM alone or neutrophils alone. Neutrophils incubated with AMX under identical conditions also killed significantly more bacteria than either AMX alone or control neutrophils, but there was no evidence of synergism between AMX and neutrophils. Conclusions Neutrophils possess a concentrative transport system for AZM that may enhance killing of A. actinomycetemcomitans. Its effects are most pronounced when neutrophils are greatly outnumbered by bacteria.

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Adjunctive azithromycin in the treatment of aggressive periodontitis: Microbiological findings of a 12-month randomized clinical trial

Cited by 27 publications

References 39 publications

Antibiotic effects against periodontal bacteria in organ cultured tissue

Antibiotic effects against periodontal bacteria in organ cultured tissue

Non‐surgical periodontal therapy with systemic antibiotics in patients with untreated chronic periodontitis: a systematic review and meta‐analysis

Azithromycin Enhances Phagocytic Killing of Aggregatibacter actinomycetemcomitans Y4 by Human Neutrophils

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