Different antibiotic protocols in the treatment of severe chronic periodontitis: A 1-year randomized trial.

Abstract

AIM:

To evaluate the clinical effects of different dosages of metronidazole (MTZ) and durations of MTZ + amoxicillin (AMX) in the treatment of generalized chronic periodontitis (GChP).

MATERIAL AND METHODS:

Subjects with severe GChP were randomly assigned to receive scaling and root planing (SRP)-only, or combined with 250 or 400 mg of MTZ + AMX (500 mg) thrice a day (TID), for 7 or 14 days. Subjects were monitored for 1 year.

RESULTS:

One hundred and nine subjects were enrolled. At 1 year, 61.9% and 63.6% of the subjects receiving AMX + 250 or 400 mg of MTZ for 14 days, respectively, reached the clinical endpoint for treatment (≤4 sites with probing depth ≥5 mm), against 31.8% of those taking 250 or 400 mg of MTZ for 7 days (p < .05) and 13.6% of those receiving SRP-only (p < .05). Fourteen days of MTZ + AMX was the only significant predictor of subjects reaching the clinical endpoint at 1 year (OR, 5.26; 95% CI, 2.3-12.1, p = .0000). The frequency of adverse events did not differ among treatment groups (p > .05).

CONCLUSION:

The adjunctive use of 400 or 250 mg of MTZ plus 500 mg of AMX/TID/14 days offers statistically significant and clinically relevant benefits over those achieved with SRP alone in the treatment of severe GChP. The added benefits of the 7-days regimen in this population were less evident. (ClinicalTrials.gov NCT02735395).

• Authors: Ivan Borges, Marcelo Faveri, Luciene Cristina Figueiredo, Poliana Mendes Duarte, Belén Retamal-Valdes, Sheyla Christinne Lira Montenegro, Magda Feres
• Journal: Journal of clinical periodontology (J Clin Periodontol) Vol. 44 Issue 8 Pg. 822-832 (Aug 2017) ISSN: 1600-051X [Electronic] United States
• PMID: 28303587 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Anti-Bacterial Agents
• Metronidazole
• Amoxicillin

Topics

• Amoxicillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Chronic Periodontitis (drug therapy, microbiology, therapy)
• Combined Modality Therapy
• Dental Scaling
• Double-Blind Method
• Female
• Humans
• Male
• Metronidazole (therapeutic use)
• Middle Aged
• Periodontal Index
• Prospective Studies
• Root Planing
• Treatment Outcome