Fluoroquinolones in the treatment of Actinobacillus actinomycetemcomitans-associated periodontitis.
BACKGROUND
Periodontitis patients harboring Actinobacillus actinmycetemcomitans (Aa) are prime candidates for systemic antibiotic therapy. Besides tetracycline and the combination of metronidazole and amoxicillin the fluoroquinolones are also believed to have antibacterial activity against Aa. The aim of the present study was to evaluate systemic ofloxacin therapy as adjunct to flap surgery.


METHODS
Twenty-five adult periodontitis patients with subgingival detection of Aa were treated with 2x200 mg/d ofloxacin for 5 days as adjunct to open flap surgery (test). Another 10 patients received only flap surgery (control). Probing depth (PD) and clinical attachment level (CAL) was recorded and subgingival plaque samples were cultivated on TSBV agar for detection of Aa at baseline as well as 3 and 12 months following therapy.


RESULTS
At 3 and 12 months following therapy mean PD at monitored sites in the test group changed from 6.8 mm (+/-1.3) to 3.6 mm (+/-1.0), 3.8 mm (+/-1.1) and CAL from 7.5 mm (+/-1.4) to 5.4 mm (+/-1.4), 5.5 mm (+/-1.3). In the control group PD changed from 6.5 mm (+/-0.7) to 4.0 mm (+/-1.7), 4.1 mm (+/-1.6) and CAL from 7.5 mm (+/-1.0) to 6.3 mm (+/-1.7), 6.4 mm (+/-1.8). P was <0.05 for CAL between groups. Three and 12 months following adjunctive systemic ofloxacin therapy, Aa was suppressed below detectable levels in 22 of 22, test patients, whereas Aa could not be recovered in only 2 of the 10 controls. (P<0.0001).


CONCLUSIONS
Systemic ofloxacin as adjunct to open flap surgery is able to suppress A. actinomycetemcomitans below detectable level in patients harboring this organism at baseline.
Kleinfelder
J W
JW
Section of Periodontology, College of Dentistry, The Ohio State University, Columbus, USA.
Mueller
R F
RF
Lange
D E
DE
D000189:Actinobacillus Infections / Q000188:drug therapy*; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects*; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D015242:Ofloxacin / Q000494:pharmacology / Q000627:therapeutic use*; D010518:Periodontitis / Q000188:drug therapy* / Q000382:microbiology* / Q000601:surgery; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D015242:Ofloxacin