[Efficacy variation of erythromycin and spiramycin on periopathogens in aggressive periodontitis. An in vitro comparative study].
OBJECTIVE
Erythromycin (ERY) and spiramycin (SPI) are the most frequently prescribed macrolides by dentists. However, the emergence of resistant anaerobic subgingival bacteria imposes an increased vigilance. This study aims to compare these macrolides efficacy on principal periopathogens.


METHODS
Twenty adult patients with aggressive periodontitis were selected and a total of 60 samples were taken from subgingival flora. Bacterial strains of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum, Peptostreptococcus micros and Actinobacillus actinomycetemcomitans were isolated according to J. Slots's rapid identification method. The susceptibilities to ERY and SPI were studied using disk diffusion susceptibility test and minimum inhibitory concentration test (MIC test).


RESULTS
The efficiency variability of ERY and SPI on the 50 isolated anaerobic periopathogens was present either interindividually (between different patients) and intra-individually (within the same patient). While 68% of the tested anaerobic bacteria were sensitive to SPI (22% resistant), only 54% were sensitive to ERY (34% resistant). Although moderate, the efficacy of SPI seemed more regular in general than ERY: it's variation coefficient (40%) is lower than the ERY one (53%). The 7 A. actinomycetemcomitans tested showed all a high resistance.


CONCLUSIONS
In a general way, the spectre of activity of SPI is stacked in that of ERY. However, this study shows a better and regular activity of SPI on the main tested periopathogens. These results are in favour of the use of SPI in periodontology when penicillins and doxycycline are not useful because specific problems are identified (allergy, pregnancy...).
Lakhssassi
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Department of Epidemiology of Infectious Disease, Laboratory of the Buccal and Biomaterial Ecosystem, Faculty of Oral Surgery-Toulouse, Université Paul-Sabatier, 3 chemin des Maraîchers, 31062 Toulouse cedex 04, France. docteurlakhssassi@yahoo.fr
Sixou
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D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D004917:Erythromycin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008826:Microbial Sensitivity Tests; D010518:Periodontitis / Q000188:drug therapy*; D015203:Reproducibility of Results; D015572:Spiramycin / Q000494:pharmacology / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D004917:Erythromycin; D015572:Spiramycin