Microbiological and clinical effects of metronidazole and amoxicillin in Actinobacillus actinomycetemcomitans associated periodontitis

Abstract

In this study, we evaluated the microbiological and clinical effects of mechanical debridement in combination with metronidazole and amoxicillin therapy in 48 patients with Actinobacillus actinomycetemcomitans‐associated periodontitis, 3 months and at least 24 months after active treatment. The results of this study showed that 47 out of 48 patients were still negative for A. actinomycetemcomitans subgingivally, at the mucous membranes, the tonsillar area and in the saliva, 2 years after therapy. The clinical results showed that a reduction of probing pocket depth, probing attachment level, bleeding index and plaque index was not only seen in the time between baseline and 3 months after therapy, but further clinical improvement was observed between 3 and 24 months after active treatment. We conclude that combined mechanical debridement and metronidazole plus amoxicillin therapy is very effective in suppressing A. actinomycetemcomitans below cultivable levels over a long period of time, suggesting elimination of this organism, and that recolonization of A. actinomycetemcomitans seems to be a rare event. The elimination of A. actinomycetemcomitans is paralleled by a further improvement of the periodontal status of the patients, even up to 24 months after active treatment.

Recommendations for the care of oral involvement in patients with systemic sclerosis

“…In the presence of a mouth or dental infection, antibiotics should be prescribed. The combination of amoxicillin and metronidazole represents the first-line therapy, especially with generalized aggressive periodontitis (47). In case of allergy or for patients receiving methotrexate as a disease-modifying agent, macrolides can be proposed.…”

Potential of Diagnostic Microbiology for Treatment and Prognosis of Dental Caries and Periodontal Diseases

“…Several studies have reported that A. actinomycetemcomitans still remained after debridement in a high proportion of sites initially infected with the bacteria (Christersson etal, 1985;Renvert etal, 1990). Some authors have shown that elimination can be achieved only by combining mechanical treatment with the use of antibiotics (Slots and Rosling, 1983;Pavicic et al, 1994).…”

Clinical Efficacy of Azithromycin as an Adjunctive Therapy to Non-Surgical Periodontal Treatment of Periodontitis: A Systematic Review and Meta-Analysis

“…The effectiveness of specific antibiotic types has been demonstrated for decades. For instance, an additional administration of amoxicillin and metronidazole has been proven to lead to a significant reduction in Aggregatibacter actinomycetemcomitans [11]. It follows, therefore, that the administration of various antibiotics would certainly be indicated in cases in which SRP alone does not produce the anticipated success due to persistent pockets or inaccessible points (e.g., furcation and concavities).…”