title: Treatment of cyclosporin-induced gingival hyperplasia with azithromycin.
abstract: BACKGROUND
  Gingival hyperplasia is a known complication of cyclosporin therapy. Although plaque control has been shown to be of benefit, gingival surgery is occasionally necessary. The aim of this study was to review the effect of a short-course therapy with azithromycin in renal transplant patients with cyclosporin-induced gingival hyperplasia.
  
  
  METHODS
  Thirty-eight patients received 500 mg/day of azithromycin for 3 consecutive days. The degree of gingival hyperplasia was classified as: 0, no gingival overgrowth; 1, mild overgrowth; 2, moderate overgrowth, and 3, severe overgrowth. Gingival bleeding and evolution of gingival hyperplasia were determined at 0 (pretreatment), 7, 30, 90 and 180 days. Cyclosporin, serum creatinine and ALT levels were simultaneously determined on the same days.
  
  
  RESULTS
  Seven patients were excluded, leaving a total of 31 included in the trial. Eleven had a score of 3, 17 a score of 2, and 3 a score of 1. The degree of gingival hyperplasia was unrelated to the dose and levels of cyclosporin. Gingival hyperplasia improved in all patients (P < 0.001, Friedman test). The degree of improvement was better when the degree of hyperplasia was lower. In 27 patients gingival hyperplasia remained absent 6 months later, 3 patients required a second course of treatment, and another required gingival surgery. Gingival bleeding, present in 28 patients when diagnosed, disappeared in all cases in 2.2 +/- 1.2 (1-7) days. No adverse effects were observed. Cyclosporin, serum creatinine, and ALT levels were not affected by treatment.
  
  
  CONCLUSIONS
  Azithromycin improves cyclosporin-associated gingival hyperplasia, especially when administered early in the process.
authors.affiliation: Nephrology Service, Hospital Central de Asturias, Oviedo, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gómez
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Nuñez
authors.forename: J E
authors.initials: JE
authors.lastname: Sánchez
authors.forename: C
authors.initials: C
authors.lastname: Corte
authors.forename: S
authors.initials: S
authors.lastname: Aguado
authors.forename: C
authors.initials: C
authors.lastname: Portal
authors.forename: J
authors.initials: J
authors.lastname: Baltar
authors.forename: J
authors.initials: J
authors.lastname: Alvarez-Grande
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005885:Gingival Hyperplasia / Q000139:chemically induced* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D017963:Azithromycin; D016572:Cyclosporine