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Scientific article
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Differential benefits of amoxicillin-metronidazole in different phases of periodontal therapy Randomized controlled crossover clinical trial

Published inJournal of periodontology, vol. 86, no. 3, p. 367-375
Publication date2015
Abstract

Background: The specific advantage of administering systemic antibiotics during initial, non- surgical therapy, or in the context of periodontal surgery is unclear. This study assessed the differential outcomes of periodontal therapy supplemented with amoxicillin-metronidazole during either the non-surgical or the surgical treatment phase. Methods: Single center, randomized placebo controlled crossover clinical trial with a one- year follow-up. Eighty participants with Aggregatibacter actinomycetemcomitans-associated moderate to advanced periodontitis were randomized into two treatment groups. A: Antibiotics (3/d 500 mg metronidazole plus 375 mg amoxicillin for 7 days) during the first, non-surgical phase of periodontal therapy (T1), and placebo during the second, surgical phase (T2). B: Placebo during T1, and antibiotics during T2. Number of sites with PD >4 mm and BOP per patient was the primary outcome. Results: 11212 sites were clinically monitored on 1870 teeth. T1 with antibiotics decreased the number of sites with PD >4 mm and BOP per patient significantly more than without (A: from 34.5 to 5.7, 84%; B: from 28.7 to 8.7, 70%, p<0.01). Twenty patients treated with antibiotics, but only 8 treated with placebo, achieved a tenfold reduction of diseased sites (p=0.007). Consequently, fewer patients of group A needed further therapy, the mean number of surgical interventions was lower and treatment time in T2 was shorter. Six months after T2 the mean number of residual pockets (A: 2.8±5.2, B: 2.2±5.0) was not significantly different and was sustained over 12 months in both groups. Conclusion: Giving the antibiotics during the first or second phase yielded similar long term outcomes, however, antibiotics in T1 resolved the disease quicker, and thus reduced the need for additional surgical intervention.

Keywords
  • Key words: Periodontitis
  • Amoxicillin
  • Metronidazole
  • Case management
Citation (ISO format)
MOMBELLI, Andrea et al. Differential benefits of amoxicillin-metronidazole in different phases of periodontal therapy Randomized controlled crossover clinical trial. In: Journal of periodontology, 2015, vol. 86, n° 3, p. 367–375. doi: 10.1902/jop.2014.140478
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Article (Published version)
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ISSN of the journal0022-3492
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