title: Clarithromycin, as an adjunct to non surgical periodontal therapy for chronic periodontitis: a double blinded, placebo controlled, randomized clinical trial.
abstract: OBJECTIVE
  Along with conventional non-surgical periodontal therapy (NSPT) systemic antimicrobials may provide more effective treatment for chronic periodontitis by targeting tissue-invasive bacteria. The aim of this randomized, placebo-controlled, double-masked clinical trial was to evaluate the adjunctive effects of oral clarithromycin (CLM) to non-surgical periodontal therapy for chronic periodontitis.
  
  
  METHODS
  40 patients were categorized into two groups: test group - scaling and root planing (SRP) plus CLM (500 mg b.i.d. for 3 days) and control group - SRP plus placebo. Clinical parameters were recorded at baseline and at 1, 3, 6, and 9 months. They included gingival index (GI), probing depth (PD), and clinical attachment level (CAL). Also microbial analysis of dental plaque was done at baseline, 3 and 9 months to estimate the levels of periodontopathic organisms using polymerase chain reaction. ANOVA, Chi-square and Bonferroni tests were used for statistical analysis.
  
  
  RESULTS
  Thirty-seven subjects completed the study and the results demonstrated that both groups displayed clinical improvements. Using a subject-based analysis, patients treated with SRP+CLM showed enhanced reductions in PD and gains in CAL (p<0.001) over time, as compared to control group. Also significant reductions in periodontopathic organisms were noticed in the test group compared to control group. However, no statistically significant differences were noted for Tannerella forsythia levels between the groups during the course of the study.
  
  
  CONCLUSIONS
  The utilisation of CLM in combination with SRP improves the efficacy of NSPT in reducing PD, improving CAL and in lessening microbial loads. Hence, CLM may be beneficial in the non-surgical treatment regimen of chronic periodontitis.
authors.affiliation: Department of Periodontics, Government Dental College & Research Institute, Bangalore 560002, India. periodontics_gdc@yahoo.co.in
authors.forename: A R
authors.initials: AR
authors.lastname: Pradeep
authors.forename: Rahul
authors.initials: R
authors.lastname: Kathariya
mesh_terms: D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D001439:Bacteroides / Q000187:drug effects; D055113:Chronic Periodontitis / Q000188:drug therapy* / Q000382:microbiology / Q000628:therapy; D017291:Clarithromycin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D010919:Placebos; D016966:Porphyromonas gingivalis / Q000187:drug effects; D016745:Root Planing; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D010919:Placebos; D017291:Clarithromycin