Macrolides and changes in the oral flora.
Macrolides have been used in dental practice for many years, and may have a role in treating periodontal disease. Increased numbers of antibiotic-resistant oral streptococci have been reported after administration of both penicillins and macrolides. We confirm these findings for erythromycin, josamycin and azithromycin, and show that small numbers of macrolide-resistant streptococci are part of the normal oral flora at baseline. Resistant organisms fill the vacuum created by the removal of sensitive strains by antibiotic treatment. Following treatment with azithromycin, periodontal bacterial pathogens such as black pigmented anaerobes and spirochaetes decrease, whereas numbers of oral streptococci increase. These changes in the oral flora indicate a return to a healthier oral environment. In our studies, no clinical problems resulted from the transient increase in macrolide-resistant streptococci.
Sefton
A M
AM
Department of Medical Microbiology, St. Bartholomew's and the Royal London School of Medicine and Dentistry, UK.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D017963:Azithromycin / Q000494:pharmacology / Q000627:therapeutic use; D004311:Double-Blind Method; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D015570:Josamycin / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D010518:Periodontitis / Q000188:drug therapy*; D013291:Streptococcus / Q000187:drug effects* / Q000254:growth & development
D000900:Anti-Bacterial Agents; D004917:Erythromycin; D017963:Azithromycin; D015570:Josamycin