Title The Adjunct Use of Azithromycin with Nonsurgical Periodontal Therapy Produces Probing Depth Reductions Similar to Metronidazole-Amoxicillin in Patients with Generalized Aggressive Periodontitis
Clinical Question For patients with generalized aggressive periodontitis treated with nonsurgical periodontal therapy, will the use of adjunct systemic azithromycin compared to the use of metronidazole-amoxicillin in combination result in greater probing depth reduction?
Clinical Bottom Line For patients with generalized aggressive periodontitis, nonsurgical periodontal therapy treatment in conjunction with systemic azithromycin produced similar probing depth reduction as metronidazole-amoxicillin and greater probing depth reduction compared to nonsurgical periodontal therapy without systemic antibiotic use.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
25966723Ercan/201545 patients -15: SCRP alone (Control) -15: SCRP + azithromycin - 15 SCRP + metronidazole & amoxicillin (M + A)Controlled Trial
Key resultsAll 3 groups of patients experienced probing depth reduction, but patients in the experimental groups showed greater probing depth reduction than patients in the control group (SCRP + azithromycin: -1.29 ± 1.39, SCRP + (M+A): -1.27 ± 0.51, control -0.79 ± 0.55). However, these differences were not statistically significant.
Evidence Search ((("generalized aggressive periodontitis"[MeSH Terms] OR ("aggressive"[All Fields] AND "periodontitis"[All Fields]) OR "aggressive periodontitis"[All Fields]) AND (systemic[All Fields] AND ("anti-bacterial agents"[Pharmacological Action] OR "anti-bacterial agents"[MeSH Terms] OR ("anti-bacterial"[All Fields] AND "agents"[All Fields]) OR "anti-bacterial agents"[All Fields] OR "antibiotics"[All Fields]))) AND ("azithromycin"[MeSH Terms] OR "azithromycin"[All Fields])) AND metronidazole-amoxicillin[All Fields]
Comments on
The Evidence
Validity: The sample size of this randomized controlled trial was small with a short follow-up time. Additionally, no immunological or microbiological parameters were considered in this study model. The experimental and control groups were similar in terms of age, gender and clinical parameters.
Applicability This information can benefit clinicians considering the use of systemic antibiotics as an adjunct to nonsurgical periodontal therapy. Patients prescribed azithromycin may be more compliant in following the antibiotic regimen because it is often easier to follow (AZT 500mg tablet once day for 3 days vs. M+A 500mg each 3 times/day).
Specialty (General Dentistry) (Periodontics)
Keywords Generalized aggressive periodontitis, Azithromycin, Metronidazole-Amoxicillin
ID# 3118
Date of submission 11/21/2016
E-mail laiv@livemail.uthscsa.edu
Author Veronica Lai, DDS
Co-author(s) e-mail
Faculty mentor Richard Finlayson, DDS
Faculty mentor e-mail finlaysonr@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available