Effects of irrigation with an antiseptic and oral administration of azithromycin on bacteremia caused by scaling and root planing.
BACKGROUND
Transient bacteremia frequently occur secondary to several periodontal procedures. The purpose of the present study is to investigate the effects of irrigation with an essential oil-containing antiseptic (EO) and oral administration of azithromycin (AZM) on bacteremia caused by scaling and root planing (SRP).


METHODS
Thirty patients with chronic periodontitis were randomly assigned to three groups (control, EO, and AZM). The EO group received quadrant subgingival irrigation with EO, and mouthrinsing was continued at home for 1 week. Oral administration of AZM was started 3 days before SRP in the AZM group. No adjunctive treatment was performed before SRP in the control group. Peripheral blood and subgingival plaque were collected at baseline and after 1 week. The second blood sample was taken 6 minutes after the initiation of quadrant SRP. The blood samples were cultured and analyzed for bacteremia. Quantitative analysis of periodontopathic bacteria in the sulcus was performed using the polymerase chain reaction Invader method.


RESULTS
Bacteremia incidence rates were 90%, 70%, and 20% for the control, EO, and AZM groups, respectively. Significant reduction of the incidence of bacteremia was shown in the AZM group only (P <0.01). Subgingival bacterial counts significantly decreased in both the EO and AZM groups (P <0.01).


CONCLUSIONS
Quadrant SRP frequently induced bacteremia. Although AZM was effective in reducing bacteremia incidence, EO showed less effectiveness.
Morozumi
Toshiya
T
Division of Periodontology, Department of Oral Biological Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Kubota
Takehiko
T
Abe
Daisuke
D
Shimizu
Taro
T
Komatsu
Yasutaka
Y
Yoshie
Hiromasa
H
D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D017963:Azithromycin / Q000008:administration & dosage*; D016470:Bacteremia / Q000382:microbiology / Q000517:prevention & control*; D058491:Bacterial Load; D001431:Bacteriological Techniques; D001439:Bacteroides / Q000302:isolation & purification; D055113:Chronic Periodontitis / Q000097:blood / Q000382:microbiology / Q000628:therapy; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D009822:Oils, Volatile / Q000627:therapeutic use; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000302:isolation & purification; D016745:Root Planing / Q000009:adverse effects*; D012459:Salicylates / Q000627:therapeutic use; D013291:Streptococcus / Q000302:isolation & purification; D013729:Terpenes / Q000627:therapeutic use; D007507:Therapeutic Irrigation
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; D009067:Mouthwashes; D009822:Oils, Volatile; D012459:Salicylates; D013729:Terpenes; C057473:Listerine; D017963:Azithromycin