Systemic azithromycin as an adjunct to scaling and root planing in patients with stage III/IV periodontitis: 12-month results of a randomized controlled clinical trial

Povšič, Katja; Čuk, Katarina; Milavec, Suzana; Erčulj, Vanja; Seme, Katja; Gašperšič, Rok

doi:10.1007/s00784-021-03906-8

Cited by 7 publications

(15 citation statements)

References 55 publications

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“…These studies were conducted in Asia [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], South America [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ], Europe [ 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ], and Australia [ 81 , 82 ]. They were mostly single-centered [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ...…”

Section: Resultsmentioning

confidence: 99%

“…They were mostly single-centered [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 78 , 80 , 81 , 82 ], used a parallel-group approach [ 53 , 54 , 55 , 56 , 57 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , …”

Section: Resultsmentioning

confidence: 99%

“…These studies defined their participants as having chronic [ 53 , 56 , 57 , 59 , 60 , 65 , 68 , 70 , 71 , 78 , 79 ], aggressive [ 54 , 61 , 62 , 63 , 64 , 67 , 72 , 73 , 75 , 80 ], severe or advanced [ 55 , 58 , 69 ], moderate-to-advanced [ 74 , 76 , 81 , 82 ], Stage III and Stage IV [ 77 ], or mild-to-moderate [ 66 ] periodontitis. Twelve studies included smokers as their subjects [ 54 , 56 , 66 , 67 , 68 , 70 , 71 , 74 , 76 , 77 , 79 , 80 ]. The mean age of the subjects ranged from 20.1 to 58.5 years old.…”

Section: Resultsmentioning

confidence: 99%

“…Oral hygiene instruction was given to the subjects as part of the treatment, except in five studies [ 57 , 60 , 66 , 73 , 75 ]. Subgingival debridement was provided in one stage [ 55 , 58 , 61 , 62 , 63 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ] or multiple stage [ 53 , 54 , 56 , 67 , 68 , 70 , 71 , 77 , 78 , 79 , 80 , 81 , 82 ]. Fonseca et al [ 66 ] used both approaches in their study.…”

Section: Resultsmentioning

confidence: 99%

“…The treatments were mainly provided by periodontists, dentists, and dental hygienists [ 55 , 56 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 73 , 74 , 78 , 81 , 82 ]. Antibiotics that were used as adjuncts in the included studies were AMOX+MET [ 58 , 62 , 65 , 70 , 71 , 72 , 73 , 75 , 76 , 81 , 82 ], AZ [ 54 , 55 , 56 , 57 , 66 , 67 , 68 , 70 , 74 , 77 , 81 , 82 ], MET [ 71 , 78 , 80 ], clarithromycin (CLM) [ 60 , 61 , 64 ], moxifloxacin (MOX) [ 62 , 63 ], doxycycline (DOX) […”

Section: Resultsmentioning

confidence: 99%

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Systemic Antibiotics as an Adjunct to Subgingival Debridement: A Network Meta-Analysis

et al. 2022

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This review aimed to evaluate the effectiveness of systemic antibiotics as adjunctive treatment to subgingival debridement in patients with periodontitis. Randomized controlled trials were included that assessed the effectiveness of systemic antibiotics in improving periodontal status, indicated by clinical attachment gain level, probable pocket depth reduction, and bleeding on probing reduction of patients with any form of periodontitis at any follow-up time. Network meta-analyses with a frequentist model using random effects was employed to synthesize the data. The relative effects were reported as mean difference with a 95% confidence interval. Subsequently, all treatments were ranked based on their P-scores. A total of 30 randomized controlled trials were included in this network meta-analyses. Minimally important clinical differences were observed following the adjunctive use of satranidazole, metronidazole, and clindamycin for clinical attachment gain level and probable pocket depth reduction. For bleeding on probing reduction, minimally important clinical differences were observed following the adjunctive use of metronidazole and a combination of amoxycillin and metronidazole. However, the network estimates were supported by evidence with certainty ranging from very low to high. Therefore, the findings of this network meta-analyses should be interpreted with caution. Moreover, the use of these antibiotics adjunct to subgingival debridement should be weighed against possible harm to avoid overuse and inappropriate use of these antibiotics in patients with periodontitis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Systemic Antibiotics as an Adjunct to Subgingival Debridement: A Network Meta-Analysis

et al. 2022

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Systemic azithromycin versus amoxicillin/metronidazole as an adjunct in the treatment of periodontitis: a systematic review and meta‐analysis

Atieh,

Shah,

Hakam

et al. 2023

Australian Dental Journal

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BackgroundThe use of systemic azithromycin (AZT) and amoxicillin/metronidazole (AMX/MTZ) as adjuncts provided additional clinical and microbiological benefits over subgingival instrumentation alone. However, the superiority of one antibiotic regimen over another has not been proven. Therefore, the aim of this systematic review and meta‐analyses was to evaluate the clinical efficacy and safety of subgingival instrumentation (SI) in conjunction with the systemic use of AZT or AMX/MTZ for the treatment of periodontitis from current published literature.MethodsElectronic databases were searched to identify randomized controlled trials (RCTs), controlled clinical trials, prospective and retrospective human studies that compared the adjunctive use of systemic AZT to AMX/MTZ with SI in the treatment of periodontitis. The eligibility criteria were defined based on the participant (who had periodontitis), intervention (SI with adjunctive use of systemic AZT), comparison (SI with adjunctive use of systemic AMX/MTZ), outcomes (primary outcome: changes in probing pocket). The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analysed using a statistical software program.ResultsFive studies with 151 participants with periodontitis were included in the present review. Of these, 74 participants received adjunctive AZT, while the remaining participants received AMX/MTZ as an adjunct to SI. The adjunctive use of AZT and AMX/MTZ had comparable changes in probing pocket depths at 1–3 months with no statistically significant difference (mean difference (MD) 0.01; 95% CI –0.20 to 0.22; P = 0.94). The adjunctive use of AZT had significantly fewer number of residual sites with probing pocket depths of ≥5 mm at 1–3 months compared to the adjunctive use of AMX/MTZ (MD –3.41; 95% CI –4.73 to –2.10; P < 0.0001). The prevalence rates of adverse events among participants who received AZT and AMX/MTZ were 9.80% and 14.8%, respectively. The meta‐analysis showed that the difference between the two groups was not statistically significant (risk ratio 0.69; 95% CI 0.28 to 1.72; P = 0.43).ConclusionsWithin the limitation of this review, there was no superiority between AZT and AMX/MTZ in terms of mean changes in probing pocket depths, clinical attachment level, bleeding on probing at 1–3 months. AZT seem to be associated with less sites with residual probing pocket depths of ≥5 mm at 1–3 months and fewer adverse events compared with AMX/MTZ. © 2023 Australian Dental Association.

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Adjunctive Systemic Azithromycin with Nonsurgical Periodontal Treatment: Effects on Clinical Parameters in Smokers with Periodontitis

Camgöz¹,

Bağiş²,

Ünsal³

2023

Acta Stomatol Croat

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Objectives Smokers with periodontitis are therapeutically challenging. Azithromycin (AZM) may be used as an adjunct to periodontal treatment. The aim of this randomized, double-blind, controlled clinical study was to determine the effect of azithromycin in shallow, moderate, and deep pocket depths in smokers when combined with non-surgical periodontal treatment. Material and methods Forty-nine patients who smoked at least 20 cigarettes per day for more than 5 years were included in the study; however only 40 completed it. The number of teeth, plaque index (PI), gingival index (GI), PPD, CAL, bleeding on probing (BOP) and gingival recession were recorded at baseline and months 1, 3 and 6. The pocket depths (PD) were grouped as shallow, moderate, and deep. Twenty-four patients assigned to the AZM+ (test) group received AZM (500 mg tablets) once a day for 3 days, beginning on the first day of SRP. Results The decline in the total number of pockets in all groups was statistically significant from baseline to 1 st , baseline to 3 rd , baseline to 6 th ; and from 1 st to 3 rd and 1 st to 6 th months. There was a statistically significant increase in the number of shallow pockets between baseline and 3 rd , baseline and 6 th ; and 1 st and 6 th months (p=0.000) for both groups. Conclusion Antibiotic administration significantly increased the number of shallow pockets at all time points. However, larger scale controlled clinical studies are needed to verify the efficiency of AZM in smoker periodontitis patients.

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Systemic azithromycin as an adjunct to scaling and root planing in patients with stage III/IV periodontitis: 12-month results of a randomized controlled clinical trial

Cited by 7 publications

References 55 publications

Systemic Antibiotics as an Adjunct to Subgingival Debridement: A Network Meta-Analysis

Systemic Antibiotics as an Adjunct to Subgingival Debridement: A Network Meta-Analysis

Systemic azithromycin versus amoxicillin/metronidazole as an adjunct in the treatment of periodontitis: a systematic review and meta‐analysis

Adjunctive Systemic Azithromycin with Nonsurgical Periodontal Treatment: Effects on Clinical Parameters in Smokers with Periodontitis

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