Effects of Penicillin and Erythromycin on the Clinical Parameters of the Periodontium

Abstract

The clinical effects of systemic penicillin and erythromycin on the periodontium were investigated. There are only a few studies of the effects of these antibiotics on clinical periodontal parameters. Of the 72 subjects in the study, 24 belonged to the penicillin group, 21 to the erythromycin group and 27 to the control group. Plaque and gingival indices, tooth mobility, and probing depths of gingival pockets were recorded before the drug treatment. Radiographs were taken. Both antibiotics decreased plaque, and erythromycin also decreased gingivitis. In the penicillin group 10 of the 24 patients developed abscesses during the study, and the studied clinical parameters worsened. These patients had more severe periodontitis initially than the persons with no acute reaction. The clinical changes had returned to the baseline level by 12 weeks after the antibiotic treatments. There were no significant or lasting effects of antibiotic treatment alone in patients with overt periodontitis.

The periodontal abscess: a review

“…There is scarce information available on the microflora of gingival abscesses, or other type of abscesses with other distinct etiology. The exception may be the studies of the microflora of abscesses related with systemic antibiotic intake in periodontitis patients, without mechanical treatment (Helovuo & Paunio 1989, Helovuo et al 1993, Topoll et al 1990. In this type of periodontal abscesses, besides an occurrence of periodontal pathogens similar to other abscesses in periodontitis (Topoll et al 1990), opportunistic bacteria were detected, and Staphylococcus aureus was found in abscesses of patients with previous penicillin intake.…”

“…Treatment with systemic antibiotics without subgingival debridement in patients with advanced periodontitis may also cause abscess formation (Helovuo & Paunio 1989, Helovuo et al 1993, Topoll et al 1990). Topoll et al (1990) reported on the development of multiple abscesses (from 4 to 12) in 10 untreated periodontal patients, who received systemic antibiotic therapy (penicillin, tetracycline or megacillin) for non-oral infections.…”

“…It has been attributed to a likely change in the composition of the subgingival microbiota, leading to a superinfection (Helovuo et al 1993). This condition was evaluated by Helovuo and co-workers (Helovuo & Paunio 1989, Helovuo et al 1993, studying 72 patients with untreated periodontitis, who were followed for 12 weeks, after intake of systemic antibiotics for non-oral reasons. Patients were divided into 3 groups according to the antibiotic used: penicillin, erythro-mycin and control (no antibiotic).…”

Antibiotic resistance of subgingival species during and after antibiotic therapy

“…The remarkable success of penicillin in treating bacterial infections quickly stimulated a great deal of scientific effort towards the search for other antibiotics. A few studies have evaluated the effect of amoxicillin alone on the microbiological and clinical parameters of periodontal disease (Helovuo & Paunio 1989, Helovuo et al 1993, Abu-Fanas et al 1991a, Hull et al 1989). Metronidazole and amoxicillin, a semisynthetic penicillin, have been used for the treatment of advanced periodontitis.…”

Systemic anti-microbial agents used in periodontal therapy

“…[70] Thus, administration of beta-lactamase sensitive penicillins is not generally recommended and in some cases, may accelerate periodontal destruction. [7172] The mechanism can be circumvented by the use of a β- lactamase inhibitor such as clavulanic acid, and this is used in the combination of amoxycillin with clavulanic acid in Augmentin. Augmentin is available as 375 mg or 625 mg, tablet which contain 250 mg and 500 mg of amoxicillin, respectively, and 125 mg clavulanic acid (Same amount of clavulanic acid is present in 375 mg and 625 mg tablets).…”