Comparison of azithromycin and oral hygiene program in the treatment of cyclosporine-induced gingival hyperplasia.
BACKGROUND
It has been shown that azithromycin improves cyclosporine-induced gingival hyperplasia (GH), but its efficacy was never compared against an efficient oral hygiene program (OHP). The aim of this study was to analyze the effects of azithromycin plus OHP versus OHP alone in patients with cyclosporine-induced GH.


METHODS
After periodontal evaluation, 20 renal transplant recipients received detailed oral hygiene instructions and a complete OHP, and were randomized to control (OHP) or azithromycin groups (OHP plus azithromycin). Patients were re-evaluated after 15 and 30 days. Both groups were similar in time after transplant, age, gender, cyclosporine dose, and cyclosporine through level and serum creatinine. The control group had fewer patients using calcium cannel blockers (10% vs. 70%, p = 0.02).


RESULTS
All patients improved in pain, halitosis, and gum bleeding after OHP. The control group did not improve plaque index (PI) or GH. In contrast, baseline PI decreased from 1.52 +/- 0.28 to 0.50 +/- 0.16 on day 15 (p < 0.01) and to 0.46 +/- 0.14 on day 30 (p < 0.01) in the azithromycin group, and the GH score decreased from 1.9 +/- 0.27 to 0.90 +/- 0.27 on day 15 (p < 0.05) and to 0.70 +/- 0.21 on day 30 (p < 0.01).


CONCLUSIONS
Azithromycin associated to efficient OHP induced a striking reduction in cyclosporine-induced GH, while efficient OHP alone improved oral symptoms but did not decrease cyclosporine-induced GH.
Ramalho
Vera L C
VL
Division of Nephrology, Hospital de Base, São José do Rio Preto Medical School, S. J. Rio Preto, SP, Brazil.
Ramalho
Horácio J
HJ
Cipullo
José P
JP
Azoubel
Reinaldo
R
Burdmann
Emmanuel A
EA
D000328:Adult; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005885:Gingival Hyperplasia / Q000139:chemically induced* / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D009910:Oral Hygiene; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D017963:Azithromycin; D016572:Cyclosporine