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

Buset, Sabrina Lill; Zitzmann, Nicola U.; Weiger, Roland; Walter, Clemens

doi:10.1007/s00784-015-1499-z

Cited by 24 publications

(16 citation statements)

References 69 publications

(185 reference statements)

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“…Regarding the healing time post NSPT, the evidence indicates a marked reduction of PPD after three months. However, in the initial deep sites, wound healing seems to need more time [21]. The reduction in PPD obtained in the AZM group in this investigation coincides with these healing times (Fig.…”

Section: Discussionsupporting

confidence: 81%

“…These results differ from those described in previous studies, where no signi cant differences between study groups were observed at any time points [13,18,19]. Otherwise, previous research [20,21] reported a signi cant reduction in the average PPD, consistent with this study. From baseline to the third month post NSPT, a signi cant increase in the mean number of sites with PPD 1-3 mm was observed in the test group (Fig.…”

Section: Discussioncontrasting

confidence: 67%

“…On the contrary, previous studies reported that the effectiveness of AZM as an adjunct to NSPT does not depend on the type of protocol used [21,31]. The selection of AZM dosage may be controversial, because the approved dosages in the United States (5-day regimen, rst dose of 500 mg and then 250 mm daily) and in Europe (3 day regimen of 500 mg daily) are different.…”

Section: Discussionmentioning

confidence: 98%

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Effect of Periodontal Debridement Plus Systemic Azithromycin v/s Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.

Navarrete

Oñate

Loyola

et al. 2020

Preprint

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Background: Recently, it has been suggested that azithromycin (AZM) may be a useful adjunct to non-surgical periodontal therapy (NSPT). However, current scientific evidence is still not conclusive as to its efficacy as an adjunct of NSPT. This study aimed to evaluate the effect of the systemic administration of AZM as an adjunct to NSPT on the clinical and microbiological variables of patients with periodontitis.Methods: Eighteen volunteers with Periodontitis received NSPT combined with placebo or AZM (500 mg/day) for 3 days (n=9/group). They were monitored clinically for probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BoP) at baseline and during the first, third and sixth month and monitored microbiologically at baseline and at 3 and 6 months after therapy. The microbiological variables were detected by conventional polymerase chain reaction tests. The normality was checked using the Shapiro-Wilk test. The level of statistical significance was measured by the unpaired t-test, Mann-Whitney U, Fisher’s exact and Chi-Square tests.Results: Fourteen patients completed the study (n=7/group). The group receiving NSPT + AZM presented with a significantly lower mean PPD at 3 (p = 0.05) and 6 months (p = 0.04) with a greater probing depth reduction (p = 0.02). Moreover, at the third month post NSPT, there was a significant increase in the number of sites with a PPD 1–3 mm (p < 0.001) and a decrease in the number of sites with a PPD 4–6 mm (p < 0.001). In addition, a significant decrease in the mean number of sites with a PPD ≥ 7 mm (p = 0.04) was detected at 6 months post treatment. There was also a significant decrease in BoP at 1 (p = 0.01), 3 (p < 0.001) and 6 (p = 0.01) months post intervention. Conclusions: AZM as an adjuvant to NSPT provides additional beneficial effects for PPD and BoP compared to NSPT alone. This could be related to its anti-inflammatory properties more than to its antibiotic characteristics.Trial registration: ClinicalTrials.gov: NCT03629288. https://clinicaltrials.gov/ct2/show/NCT03629288Retrospectively registered on August 14, 2018.

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Section: Discussionsupporting

confidence: 81%

Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 98%

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Effect of Periodontal Debridement Plus Systemic Azithromycin v/s Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.

Navarrete

Oñate

Loyola

et al. 2020

Preprint

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“…However, the authors warned of some risk of bias in some of the studies. Furthermore, there was no evidence of superiority of Az over A+M …”

Section: Discussionmentioning

confidence: 94%

Comparison of adjunctive azithromycin and amoxicillin/metronidazole for patients with chronic periodontitis: preliminary randomized control trial

Saleh¹,

Gómez-Rincón²,

Tan

et al. 2016

Australian Dental Journal

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“…y col. 13 en el 2015, encontraron mediante una revisión sistemática un beneficio potencial de la administración sistémica de azitromicina como adyuvante a la terapia periodontal no quirúrgica en pacientes con periodontitis crónica.…”

Section: Introductionunclassified

Eficacia de la Azitromicina asociada al raspado y alisado radicular en periodontitis crónica

Gómez

Aguilar

2017

Rev. Clin. Periodoncia Implantol. Rehabil. Oral

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RESUMENObjetivo: evaluar la eficacia de la azitromicina asociada al RAR asociada al (raspado y alisado radicular) en pacientes con periodontitis crónica. Material y método: El presente ensayo clínico paralelo aleatorizado, controlado y triple ciego, se desarrolló en la Clínica Estomatológica de la Universidad Católica Los Ángeles de Chimbote (Trujillo, Perú), entre marzo y diciembre de 2015. Participaron 30 pacientes adultos, distribuidos aleatoriamente en 2 grupos, designados con las letras A y B, de 15 integrantes cada uno. Cada paciente fue evaluado periodontalmente antes de realizarle el raspado y alisado radicular y optimización de las técnicas de higiene. A los pacientes del grupo A se les indicó tratamiento antibiótico con Azitromicina 500 mg por vía oral cada 24 horas durante 3 días y al grupo B se les indicó un placebo con las mismas características físicas del antibiótico escogido. Los pacientes fueron evaluados a los 3, 4 y 5 meses. La eficacia fue evaluada mediante el test T de Student para comparación de medias, considerando un nivel de significancia para los valores de p<0,05. Resultados: Se encontró que ambos grupos lograron mejorar la profundidad de sondaje y el nivel de inserción clínica sin embargo no presentaron diferencias estadísticamente significativas entre ellos. Conclusión: La azitromicina asociada al RAR no es eficaz como terapia coadyuvante en pacientes con periodontitis crónica. PALABRAS CLAVE:Azitromicina, raspado y alisado radicular, periodontitis crónica Rev. Clin. Periodoncia Implantol. Rehabil. Oral Vol. 10(1); 33-37, 2017. ABSTRACTObjective: To evaluate the efficacy of azithromycin associated with the RAR associated with (scaling and root planing) in patients with chronic periodontitis. Material and Methods: This clinical trial parallel randomized, controlled, triple blind, was developed in the Stomatology Clinic of the Catholic University Los Angeles of Chimbote (Trujillo, Peru), between March and December 2015. The participants were 30 adult patients randomized 2 groups, designated by the letters A and B of 15 members each. Each patient was evaluated periodontally before Give you the scaling and root planing and optimization hygiene techniques. Patients in group A, were prescribed antibiotic treatment with azithromycin 500 mg orally every 24 hours for 3 days. While, group B were prescribed a placebo with the same physical characteristics of the antibiotic chosen. Patients were evaluated at 3, 4 and 5 months. The efficacy was evaluated using the Student t test to compare means, considering a level of significance for the values of p <0.05. Results: It was found that both groups were able to improve probing depth and clinical attachment level however no statistically significant differences between them. Conclusion: Azithromycin associated with the RAR is not effective as adjunctive therapy in patients with chronic periodontitis.

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

Abstract: When contraindications for the standard antibiotics are present, azithromycin (AZM) may be considered as alternative systemically administered antibiotic drug in selected cases of chronic periodontitis.

Cited by 24 publications

References 69 publications

Effect of Periodontal Debridement Plus Systemic Azithromycin v/s Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.

Effect of Periodontal Debridement Plus Systemic Azithromycin v/s Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.

Comparison of adjunctive azithromycin and amoxicillin/metronidazole for patients with chronic periodontitis: preliminary randomized control trial

Eficacia de la Azitromicina asociada al raspado y alisado radicular en periodontitis crónica

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

Abstract: When contraindications for the standard antibiotics are present, azithromycin (AZM) may be considered as alternative systemically administered antibiotic drug in selected cases of chronic periodontitis.

Cited by 24 publications

References 69 publications

Effect of Periodontal Debridement Plus Systemic Azithromycin v/s&nbsp;Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.

Effect of Periodontal Debridement Plus Systemic Azithromycin v/s&nbsp;Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.

Comparison of adjunctive azithromycin and amoxicillin/metronidazole for patients with chronic periodontitis: preliminary randomized control trial

Eficacia de la Azitromicina asociada al raspado y alisado radicular en periodontitis crónica

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Effect of Periodontal Debridement Plus Systemic Azithromycin v/s Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.

Effect of Periodontal Debridement Plus Systemic Azithromycin v/s Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.