Systemic antibiotics and tooth loss in periodontal disease.
Systemic antibiotics have been recommended for the treatment of destructive periodontal disease. Our goal was to relate antibiotic use for medical or dental reasons to subsequent tooth loss in a cohort of 12,631 persons with destructive periodontal disease. After adjustment for age, smoking, and other confounders, the dispensing of antibiotics for 1-13 days, 14-20 days, or 21 or more days was not associated with reduced tooth loss [Adjusted rate ratio (RR) = 1.0; 95% Confidence Interval (CI) = 0.8-1.1; RR = 1.2; 95% CI = 0.9-1.4, and RR =1.2, 95% CI =1.0-1.3, respectively]. Numerous subgroup analyses were consistent with these overall null findings, with two exceptions: Longer courses of tetracyclines were associated with reduced tooth loss among persons receiving periodontal care, and penicillin was associated with reduced tooth loss among persons with more severe disease. Long-term, larger randomized trials are needed to provide evidence that antibiotics reduce tooth loss when used in the management of destructive periodontal disease.
Cunha-Cruz
J
J
University of Washington, Dental Public Health Sciences, B509, 1959 NE Pacific Street, Box 357475, Seattle, WA 98195-7475, USA. silvajcc@u.washington.edu
Hujoel
P P
PP
Maupome
G
G
Saver
B
B
D000900:Anti-Bacterial Agents / Q000145:classification / Q000627:therapeutic use*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013812:Therapeutics; D016388:Tooth Loss / Q000150:complications* / Q000276:immunology / Q000517:prevention & control
D000900:Anti-Bacterial Agents