Adjunctive azithromycin in the treatment of aggressive periodontitis: microbiological findings of a 12-month randomized clinical trial

J Dent. 2012 Jul;40(7):556-63. doi: 10.1016/j.jdent.2012.03.004. Epub 2012 Mar 20.

Abstract

Objectives: To compare the subgingival microbiological outcomes of azithromycin or placebo as adjuncts to scaling and root planing (SRP) in the treatment of aggressive periodontitis (AgP), and to secondarily evaluate the microbiological effect of supragingival scaling in AgP patients.

Methods: Twenty-four AgP subjects 13-26 years of age received a 15-day programme of supragingival scaling (SC) and were then randomly assigned to SRP with systemic azithromycin or placebo. Subgingival samples were taken with sterile paper points at baseline, 15 days after SC, and at 3, 6 and 12 months following SRP. Microbiological analysis was performed by the checkerboard DNA-DNA hybridization.

Results: Changes in bacterial levels from baseline to 15 days after SC were similar in the 2 groups. When subjects were analysed as a single group, significant reductions after SC were observed for Actinomyces gerencseriae, Capnocytophaga ochracea, and Treponema denticola. During the 12-month follow-up, levels of most of the bacteria decreased in both groups in a similar pattern. For instance, Actinomyces israelli, Veillonella parvula, Streptococcus gordonii, C. ochracea, Eikenella corrodens, Eubacterium nodatum, Fusobacterium periodonticum and Fusobacterium nucleatum ssp. polymorphum decreased significantly within the groups.

Conclusions: Azithromycin was ineffective in lowering the subgingival levels of important putative periodontal pathogens in young AgP subjects compared to placebo.

Clinical significance: Scaling and root planing with adjunctive systemic azithromycin provides little additional benefit compared to placebo in reductions of major subgingival periodontal pathogens.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actinomyces / drug effects
  • Adolescent
  • Adult
  • Aggressive Periodontitis / microbiology
  • Aggressive Periodontitis / therapy*
  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / therapeutic use*
  • Bacteria / classification
  • Bacteria / drug effects
  • Capnocytophaga / drug effects
  • Dental Plaque / microbiology
  • Dental Scaling / methods*
  • Double-Blind Method
  • Eikenella corrodens / drug effects
  • Eubacterium / drug effects
  • Follow-Up Studies
  • Fusobacterium / drug effects
  • Fusobacterium nucleatum / drug effects
  • Humans
  • Placebos
  • Prevotella intermedia / drug effects
  • Root Planing*
  • Streptococcus gordonii / drug effects
  • Treatment Outcome
  • Treponema denticola / drug effects
  • Veillonella / drug effects
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Placebos
  • Azithromycin