Benefits of adjunctive moxifloxacin in generalized aggressive periodontitis: a subgroup analyses in Aggregatibacter actinomycetemcomitans‐positive/negative patients from a clinical trial

Abstract

Adjunctive MOX trended toward better clinical responses in A. actinomycetemcomitans-positive patients at baseline. These results suggest that A. actinomycetemcomitans at baseline might modify the effect of adjunctive MOX in GAgP.

Empirical or microbiologically guided systemic antimicrobials as adjuncts to non‐surgical periodontal therapy? A systematic review

“…No meta‐analysis was possible based on other bacteria or other antibiotics, due to a paucity of data in the five included papers. Therefore, although some papers (Ardila & Guzman, ; Guerrero et al, ) suggested that the adjunctive antibiotics may be more effective in improving clinical outcomes in patients carrying some specific periodontopathogenic bacteria such as A. actinomycetemcomitans , this is not supported by the evidence produced by this review.…”

“…In contrast, when no antibiotics were prescribed, the change from ≥5 mm to ≤4 mm PPDs was found to be 52.6% for A. actinomycetemcomitans +ve and 60.9% for A. actinomycetemcomitans −ve individuals. Overall, both Guerrero and co‐workers and Ardila and co‐workers suggested that all patients benefitted from the antibiotic adjunct, although its clinical effect seemed to be more pronounced (but not statistically significant) in A. actinomycetemcomitans +ve patients (Ardila & Guzman, ; Guerrero et al, ). On the contrary, Cionca and co‐workers concluded that the adjunctive clinical benefits attributable to the antibiotic were obtained regardless of the baseline presence or absence of the six studied periodontal pathogens (Cionca et al, ).…”

“…All studies were RCTs and were published from 2005 to 2017. The target population was generalized aggressive periodontitis (GAgP) in three studies (Ardila & Guzman, ; Guerrero et al, ; Mestnik et al, ) and chronic periodontitis (CP) in two studies, including moderate CP (Cionca et al, ) and moderate to severe CP (Soares et al, ). The study follow‐ups ranged from 6 to 12 months.…”

“…When baseline subgingival microbial data were considered, Ardila and co‐workers (using moxifloxacin as adjunct) reported differences favouring the antibiotic group in A. actinomycetemcomitans +ve versus A. actinomycetemcomitans −ve for PPDs ≥ 7 mm (1.96 mm vs. 1.14 mm, respectively) and for PPDs 4–6 mm (0.92 mm vs. 0.51 mm, respectively) (Ardila & Guzman, ). Similarly, Guerrero and co‐workers reported that the percentage of sites changing from ≥5 mm to ≤4 mm PPDs at 6 months was 80.9% for A. actinomycetemcomitans +ve individuals treated with adjunctive antibiotics, compared to 71.1% for A. actinomycetemcomitans −ve individuals treated with adjunctive antibiotics (Guerrero et al, ).…”

“…The subgingival debridement regime ranged from a full-mouth approach in one (Ardila & Guzman, 2017) or two sessions within 24 hr (Guerrero et al, 2014) or 48 hr (Cionca et al, 2010) to a staged approach over 14 days (Mestnik et al, 2012;Soares et al, 2014). The antibiotic regimes varied too, including amoxicillin + metronidazole for most studies, albeit with differences in dose and duration (Cionca et al, 2010;Guerrero et al, 2014;Mestnik et al, 2012), an additional arm with metronidazole alone (Soares et al, 2014) and in one case moxifloxacin (Ardila & Guzman, 2017). A placebo was used for control patients in all included studies.…”